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Home My WebLink About2005-328r INDIAN RIVER COUNTY GRANT CONTRACT This Grant Contract ("Contract") entered into effective this 300 day of October 2005 , by and between Indian River County, a political subdivision of the State of Florida ; 1840 25th Street, Vero Beach , Florida , 32960-3365 ; and The Center for Emotional and Behavioral Health ( Recipient) , of: The Center for Emotional and Behavioral Health (CEBH ) 119037 th Street Vero Beach , Florida 32960 Parenting Education Group Background Recitals A. The County has determined that is in the public interest to promote healthy children in a healthy community. B . The County adopted Ordinance 99- 1 on January 19 , 1999 ("Ordinance") , and established the Children 's Services Advisory Committee to promote healthy children in a healthy community, and to provide a unified system of planning and delivery within which children 's needs can be identified , targeted , evaluated and addressed . C . The Children 's Services Advisory Committee has issued a request for proposals from individuals and entities that will assist the Children 's Services Advisory Committee in fulfilling its purpose . D . The proposal submitted to the Children 's Services Advisory Committee and the recommendation of the Children 's Services Advisory Committee have been reviewed by the County. E . The Recipient, by submitting a proposal to the Children 's Services Advisory Committee , has applied for a grant of money ("Grant") for the Grant Period (as such term is hereinafter defined ) on the terms and conditions set forth herein . F . The County has agreed to provide such Grant funds to the Recipient for the Grant Period (such term is hereinafter defined ) on the terms and conditions set forth herein . NOW THEREFORE , in consideration of the mutual covenants and promises herein contained , and other good and valuable consideration , the receipt and adequacy of which are hereby acknowledged , the parties agree as follows : 1 . Background Recitals . The background recitals are true and correct and form a material part of this contract. 2 . Purpose of the Grant. The Grant shall be used only for the purposes set forth in the complete proposal submitted by the Recipient , attached hereto as Exhibit "A" and incorporated herein by this reference (such purposes hereinafter referenced as "Grant Purposes") . 3 . Term . The Recipient acknowledges and agrees that the Grant is limited to the fiscal year 2005/2006 ("Grant Period") . The Grant Period commences on October 1 , 2005 and ends on September 30 , 2006 . - 1 - INDIAN RIVER COUNTY GRANT CONTRACT This Grant Contract ("Contract") entered into effective this 300 day of October 2005 , by and between Indian River County, a political subdivision of the State of Florida ; 1840 25th Street, Vero Beach , Florida , 32960-3365 ; and The Center for Emotional and Behavioral Health ( Recipient) , of: The Center for Emotional and Behavioral Health (CEBH ) 119037 th Street Vero Beach , Florida 32960 Parenting Education Group Background Recitals A. The County has determined that is in the public interest to promote healthy children in a healthy community. B . The County adopted Ordinance 99- 1 on January 19 , 1999 ("Ordinance") , and established the Children 's Services Advisory Committee to promote healthy children in a healthy community, and to provide a unified system of planning and delivery within which children 's needs can be identified , targeted , evaluated and addressed . C . The Children 's Services Advisory Committee has issued a request for proposals from individuals and entities that will assist the Children 's Services Advisory Committee in fulfilling its purpose . D . The proposal submitted to the Children 's Services Advisory Committee and the recommendation of the Children 's Services Advisory Committee have been reviewed by the County. E . The Recipient, by submitting a proposal to the Children 's Services Advisory Committee , has applied for a grant of money ("Grant") for the Grant Period (as such term is hereinafter defined ) on the terms and conditions set forth herein . F . The County has agreed to provide such Grant funds to the Recipient for the Grant Period (such term is hereinafter defined ) on the terms and conditions set forth herein . NOW THEREFORE , in consideration of the mutual covenants and promises herein contained , and other good and valuable consideration , the receipt and adequacy of which are hereby acknowledged , the parties agree as follows : 1 . Background Recitals . The background recitals are true and correct and form a material part of this contract. 2 . Purpose of the Grant. The Grant shall be used only for the purposes set forth in the complete proposal submitted by the Recipient , attached hereto as Exhibit "A" and incorporated herein by this reference (such purposes hereinafter referenced as "Grant Purposes") . 3 . Term . The Recipient acknowledges and agrees that the Grant is limited to the fiscal year 2005/2006 ("Grant Period") . The Grant Period commences on October 1 , 2005 and ends on September 30 , 2006 . - 1 - 4 . Grant Funds and Payment. The approved Grant for the Grant Period is : FOUR THOUSAND , FIVE HUNDRED THIRTEEN DOLLARS ($4 , 513 . 00 ) . The County agrees to reimburse the Recipient from such Grant funds for actual documented costs incurred for the Grant Purposes provided in accordance with this Contract . Reimbursement requests may be made no more frequently than monthly. Each reimbursement request shall contain the information , at a minimum , that is set forth in Exhibit "B" , attached hereto and incorporated herein by this reference . All reimbursement requests are subject to audit by the County. In addition , the County may require additional documentation of expenditures , as it deems appropriate . 5 . Additional Obligation of Recipient. 5 . 1 . Records . The Recipient shall maintain adequate internal controls in order to safeguard the Grant . In addition , the Recipient shall maintain adequate records fully to document the use of the Grant funds for at least three (3 ) years after the expiration of the Grant Period , The County shall have access to all books , records , and documents as required in this Section for the purpose of inspection or audit during normal business hours at the County's expense , upon five (5 ) days prior to written notice . 5 . 2 . Compliance with Laws . The Recipient shall comply at all times with all applicable federal , state , and local laws and regulations . 5 . 3 . Quarterly Performance Reports , The Recipient shall submit quarterly, cumulative , Performance Reports to the Human Services Department of the County, within fifteen ( 15 ) business days following : December 31 , March 31 , June 30 and September 30 . 5 .4 . Audit Requirements . If Recipient receives $25 , 000 , or more in aggregate , from all Indian River County government funding sources , the Recipient is required to have an audit completed by an independent certified public accountant at the end of the Recipient's fiscal year. Within 120 days of the end of the Recipient's fiscal year, the Recipient shall submit the audit to the Indian River County Office of Management and Budget . The fiscal year will be as reported on the application for funding , and the Recipient agrees to notify the County prior to any change in the fiscal period of Recipient. The Recipient acknowledges that the County may deny funding to any Recipient if an audit required by this Contract for the prior fiscal year is past due and has not been submitted by May 1 . 5 . 4 . 1 . The Recipient further acknowledges that, promptly upon receipt of a qualified opinion from its independent auditor, such qualified opinion shall immediately be provided to the Indian River County Office of Management and Budget. The qualified opinion shall thereupon be reported to the Board of Commissioners and funding under this Contract will cease immediately. The foregoing termination right is in addition to any other right of the County to terminate the Contract. 5 .4 . 2 . The Indian River County Office of Management and Budget reserves the right at any time to send a letter to the Recipient requesting clarification if there are any questions regarding a part of the financial statements , audit comments , or notes . 5 . 5 . Insurance Requirements . Recipient shall , no later than September 21 , 2005 provide to Indian River County Risk Management Division a certificate , or certificates , issued by an insurer, or insurers , authorized to conduct business in Florida that is rated not-less-than Category A- :VII by A . M . Best, subject to approval by Indian River County's Risk Manager, of the following types and amounts of insurance : ( i ) Commercial General Liability Insurance in an amount not less than $ 1 , 000 , 000 combined single limit for bodily injury and property - 2 - iiiiiiiiiiiiiiiiiiiiiillillillillillillilliillillillillillillilliillillillillim 4 . Grant Funds and Payment. The approved Grant for the Grant Period is : FOUR THOUSAND , FIVE HUNDRED THIRTEEN DOLLARS ($4 , 513 . 00 ) . The County agrees to reimburse the Recipient from such Grant funds for actual documented costs incurred for the Grant Purposes provided in accordance with this Contract . Reimbursement requests may be made no more frequently than monthly. Each reimbursement request shall contain the information , at a minimum , that is set forth in Exhibit "B" , attached hereto and incorporated herein by this reference . All reimbursement requests are subject to audit by the County. In addition , the County may require additional documentation of expenditures , as it deems appropriate . 5 . Additional Obligation of Recipient. 5 . 1 . Records . The Recipient shall maintain adequate internal controls in order to safeguard the Grant . In addition , the Recipient shall maintain adequate records fully to document the use of the Grant funds for at least three (3 ) years after the expiration of the Grant Period , The County shall have access to all books , records , and documents as required in this Section for the purpose of inspection or audit during normal business hours at the County's expense , upon five (5 ) days prior to written notice . 5 . 2 . Compliance with Laws . The Recipient shall comply at all times with all applicable federal , state , and local laws and regulations . 5 . 3 . Quarterly Performance Reports , The Recipient shall submit quarterly, cumulative , Performance Reports to the Human Services Department of the County, within fifteen ( 15 ) business days following : December 31 , March 31 , June 30 and September 30 . 5 .4 . Audit Requirements . If Recipient receives $25 , 000 , or more in aggregate , from all Indian River County government funding sources , the Recipient is required to have an audit completed by an independent certified public accountant at the end of the Recipient's fiscal year. Within 120 days of the end of the Recipient's fiscal year, the Recipient shall submit the audit to the Indian River County Office of Management and Budget . The fiscal year will be as reported on the application for funding , and the Recipient agrees to notify the County prior to any change in the fiscal period of Recipient. The Recipient acknowledges that the County may deny funding to any Recipient if an audit required by this Contract for the prior fiscal year is past due and has not been submitted by May 1 . 5 . 4 . 1 . The Recipient further acknowledges that, promptly upon receipt of a qualified opinion from its independent auditor, such qualified opinion shall immediately be provided to the Indian River County Office of Management and Budget. The qualified opinion shall thereupon be reported to the Board of Commissioners and funding under this Contract will cease immediately. The foregoing termination right is in addition to any other right of the County to terminate the Contract. 5 .4 . 2 . The Indian River County Office of Management and Budget reserves the right at any time to send a letter to the Recipient requesting clarification if there are any questions regarding a part of the financial statements , audit comments , or notes . 5 . 5 . Insurance Requirements . Recipient shall , no later than September 21 , 2005 provide to Indian River County Risk Management Division a certificate , or certificates , issued by an insurer, or insurers , authorized to conduct business in Florida that is rated not-less-than Category A- :VII by A . M . Best, subject to approval by Indian River County's Risk Manager, of the following types and amounts of insurance : ( i ) Commercial General Liability Insurance in an amount not less than $ 1 , 000 , 000 combined single limit for bodily injury and property - 2 - t , damage , including coverage for premises/operations , product/completed operations , contractual liability, and independent contractors ; ( ii ) Business Auto Liability Insurance in an amount not less than $ 1 , 000 , 000 per occurrence combined single limit for bodily injury and property damage , including coverage for owned autos and other vehicles , hired autos and other vehicles , non-owned autos and other vehicles ; and ( iii ) Worker's Compensation and Employer's Liability (current Florida statutory limit . ) . 5 . 6 . Insurance Administration . The insurance certificates , evidencing all required insurance coverages shall be fully acceptable to County in both form and content, and shall provide and specify that the related insurance coverage shall not be cancelled without at least thirty (30 ) calendar days prior written notice having been given the County. In addition , the County may request such other proofs and assurances as it may reasonable require that the insurance is and at all times remains in full force and effect. Recipient agrees that it is the Recipient's sole responsibility to coordinate activities among itself, the County, and the Recipient's insurer(s ) so that the insurance certificates are acceptable to and accepted by County within the time limits set forth in this Contract. The County shall be listed as an additional insured on all insurance coverage required by this Contract , except Worker's Compensation Insurance . The Recipient shall , upon ten ( 10 ) days prior written request from the County, deliver copies to the County, or make copies available for the County's inspection at Recipient's place of business , of any and all insurance policies that are required in this Contract . If the Recipient fails to deliver or make copies of the policies available to the County; fails to obtain replacement insurance or have previous insurance policies reinstated or renewed upon termination or cancellation of existing required coverages ; or fails in any other regard to obtain coverages sufficient to meet the terms and conditions of this Contract, then the County may, at its sole option , terminate this Contract . 5 . 7 . Indemnification , The Recipient shall indemnify and save harmless the County, its agents , officials , and employees from and against any and all claims , liabilities , losses , damage , or causes of action which may arise from any misconduct, negligent act, or omissions of the Recipient, its agents , officers , or employees in connection with the performance of this Contract. 5 . 8 . Public Records . The Recipient agrees to comply with the provisions of Chapter 119 , Florida Statutes (Public Records Law) in connection with this Contract. 6 . Termination . This Contract may be terminated by either party, without cause , upon thirty (30 ) days prior written notice to the other party. In addition , the County may terminate this Contract for convenience upon ten ( 10 ) days prior written notice to the Recipient if the County determines that such termination is in the public interest. 7 . Availability of Funds . The obligations of the County under this contract are subject to the availability of funds lawfully appropriated for its purpose by the Board of County Commissioners of Indian River County. 8 . Standard Terms . This Contract is subject to the standard terms attached hereto as Exhibit C and incorporated herein in its entirety by this reference . - 3 - IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date first above written . INDIAN RIVER COUNTY BOARD OF COMMISSIONERS s( By: Thomas S . Lowther, Chairman BCC Approved : Attest : J . K . Barton , Clerk ' ? By: Deputy ClerkH ' j �ti ta Approved : Jose h A. Baird County Administrator Approved as orm and legal sufficiency By: rian E . Fell , Assist ounty Att ey RECIPIENT : By. , r Th ( r for otional and Behavioral Health (CEBH ) - 4 - t , damage , including coverage for premises/operations , product/completed operations , contractual liability, and independent contractors ; ( ii ) Business Auto Liability Insurance in an amount not less than $ 1 , 000 , 000 per occurrence combined single limit for bodily injury and property damage , including coverage for owned autos and other vehicles , hired autos and other vehicles , non-owned autos and other vehicles ; and ( iii ) Worker's Compensation and Employer's Liability (current Florida statutory limit . ) . 5 . 6 . Insurance Administration . The insurance certificates , evidencing all required insurance coverages shall be fully acceptable to County in both form and content, and shall provide and specify that the related insurance coverage shall not be cancelled without at least thirty (30 ) calendar days prior written notice having been given the County. In addition , the County may request such other proofs and assurances as it may reasonable require that the insurance is and at all times remains in full force and effect. Recipient agrees that it is the Recipient's sole responsibility to coordinate activities among itself, the County, and the Recipient's insurer(s ) so that the insurance certificates are acceptable to and accepted by County within the time limits set forth in this Contract. The County shall be listed as an additional insured on all insurance coverage required by this Contract , except Worker's Compensation Insurance . The Recipient shall , upon ten ( 10 ) days prior written request from the County, deliver copies to the County, or make copies available for the County's inspection at Recipient's place of business , of any and all insurance policies that are required in this Contract . If the Recipient fails to deliver or make copies of the policies available to the County; fails to obtain replacement insurance or have previous insurance policies reinstated or renewed upon termination or cancellation of existing required coverages ; or fails in any other regard to obtain coverages sufficient to meet the terms and conditions of this Contract, then the County may, at its sole option , terminate this Contract . 5 . 7 . Indemnification , The Recipient shall indemnify and save harmless the County, its agents , officials , and employees from and against any and all claims , liabilities , losses , damage , or causes of action which may arise from any misconduct, negligent act, or omissions of the Recipient, its agents , officers , or employees in connection with the performance of this Contract. 5 . 8 . Public Records . The Recipient agrees to comply with the provisions of Chapter 119 , Florida Statutes (Public Records Law) in connection with this Contract. 6 . Termination . This Contract may be terminated by either party, without cause , upon thirty (30 ) days prior written notice to the other party. In addition , the County may terminate this Contract for convenience upon ten ( 10 ) days prior written notice to the Recipient if the County determines that such termination is in the public interest. 7 . Availability of Funds . The obligations of the County under this contract are subject to the availability of funds lawfully appropriated for its purpose by the Board of County Commissioners of Indian River County. 8 . Standard Terms . This Contract is subject to the standard terms attached hereto as Exhibit C and incorporated herein in its entirety by this reference . - 3 - EXHIBIT A (Copy of complete Request for Proposal ) EXHIBIT - A - The Center for Emotional and Behavioral Health@IRMH — Parenting Education Group — IRC - CSAC PROGRAM COVER PAGE Organization Name : The Center for Emotional and Behavioral Health @ IRMH Director: Mariamma Pyngolil, RN E-mail : mariamma.pynggliPirmh. org Address : 1190 37th Street Telephone: 772-563 -466 , Ext . 1838 Vero Beach, FL 32960 Fax : 772-770-2025 Program Director: Andrew Dobo, PSy.D . E-mail : andrew.dobona irmh. org Address : 1190 37th Street Telephone : 772-563 -4666 , Ext. 1878 Vero Beach FL 32960 Fax : 772-770-2025 j a0 g Pro ra Title: Parenting Education's roup Priority ea Addresse is intervention and educatnal Parentin Education Group Program for parents, children and adolescents with emotional problems in Indian River County. Brief Description of the Program : PH-610 Parenting Education : Programs that provide classes, groups or other educational opportunities for parents who want to acquire the knowledge and skills to be effective in their parenting role. PH-610 . 680 Parenting Skills Development: Programs that teach skills that enable parents to deal constructively and consistently with a broad spectrum of child rearing problems which may include sibling rivalry; school behavior and performance; poor self-esteem; shyness ; drug use; sexual promiscuity; and the whole range of negative acting out behaviors including whining temper tantrums, disobedience, insolence and destructiveness. Some parenting skill development programs utilize a step-by-step approach for managing specific problems and may incorporate application at home of techniques that were discussed and practiced in the classroom setting. Other programs may offer participatory family workshops, which provide opportunities for parents and children to learn and practice methods for dealing with one another in the guidance of a trained facilitator. Most training programs teach the parent a particular way of talking and relating to their children that reinforces positive behaviors and communication and decrease negative behaviors while supporting the development of a relationship that is built on fairness, mutual caring and respect. 3 IN WITNESS WHEREOF , County and Recipient have entered into this Contract on the date first above written . INDIAN RIVER COUNTY BOARD OF COMMISSIONERS s( By: Thomas S . Lowther, Chairman BCC Approved : Attest : J . K . Barton , Clerk ' ? By: Deputy ClerkH ' j �ti ta Approved : Jose h A. Baird County Administrator Approved as orm and legal sufficiency By: rian E . Fell , Assist ounty Att ey RECIPIENT : By. , r Th ( r for otional and Behavioral Health (CEBH ) - 4 - The Center for Emotional and Behavioral Health@IRMH — Parenting Education Group — IRC - CSAC SUMMARY REPORT — (Enter Information In The Black Cells On Amount Requested from Funder for 2005 / 06 $ 9 , 657 . 42 Total Proposed Program Budget for 2005 / 06 $ , 2 Percent of Total Program Budget : 67 . 2 % Current Program Funding ( 2004 / 05 ) : $ 51000 Dollar increase / ( decrease ) in request : $ 4 , 657 Percent increase / ( decrease ) in request * * : 93 . 1 % Unduplicated Number of Children to be served Individually : 125 Unduplicated Number of Adults to be served Individually : _ Unduplicated Number to be served via Group settings : _ Total Program Cost per Client : 114 . 96 * *If request increased 5 % or more, briefly explain why: Adding a new program for the inmates . Increase in wages. If these funds are being used to match another source, name the source and the $ amount : The Organization 's Board of Directors he approv�kthis application onldateJ4 jj O �+ihr � es S heyN Name of President/Chair of the Board Sig4ature Name of Executive D ' ctor/CEO 4 The Center for Emotional and Behavioral Health@IRMH — Parenting Education Group — IRC - CSAC PROPOSAL NARRATIVE A . ORGANIZATION CAPABILITY (Entire Section A not to exceed one page) 1 . Provide the mission statement and vision of your organization. Indian River Memorial Hospital strives to be the finest community based health care organization anywhere. Our values are compassion, respect, and teamwork. The Center for Emotional and Behavioral Health A IRMH is committed to provide excellence in Mental Health Care to the individual and families while responding to the needs of the changing community. Our patients can expect quality care with dignity and professionalism through the collaborative efforts of the multidisciplinary team. We will continue to support the Quality First process while working together as a team. Parenting Education Group is committed to improving lives of children and their families who are challenged by psychiatric disorders and/or behavioral problems by teaching and promoting effective parenting skills . 2 . Provide a brief summary of your organization including areas of expertise, accomplishments, and population served. CEBH is the only Baker Act receiving facility for Indian River County and the only one for children and adolescents for all of the Treasure Coast. CEBH provides behavioral health care services to children, adolescents and adults . The services include: ( 1 ) Assessment and Referral Services, (2) Inpatient Services, (3) Outpatient Services for Children and Adolescents and (4) Community Outreach. Assessment and Referral Services provides psychiatric assessment and placement in appropriate level of care 24 hours a day, 7 days a week. The services are offered to anyone seeking help in a behavioral or emotional crisis . Inpatient Services provide short-term acute care and crisis stabilization for all patients who cannot be safely managed in an outpatient setting. Inpatient services are provided on a voluntary or involuntary basis, to all three age groups . The Outpatient Services provide psychiatric and mental health care for about 388 children and adolescents . A board eligible psychiatrist trained in child and adolescent needs and unique developmental characteristics provides psychiatric care which includes comprehensive evaluations, treatment planning and medication management. Masters and doctoral level prepared therapists provide psychotherapy and counseling services to children, adolescents , and their families to enable them to cope with the emotional and behavioral issues . The outpatient services also include a summer camp (Camp Manatee Therapeutic Summer Camp) for ADHD children, experiential (ROPES teambuilding) , parenting classes, group therapy for children and adolescents, urine drug screens/drug free workplace services, and community outreach. The children receiving services range from 3 to 18 years of age. This program has demonstrated success in providing early intervention for children suffering from any emotional, behavioral disorder or acute and traumatic stress. This program also helps to maintain the children in the natural environment, thus preventing acute care hospitalization. The medical director and staff of the Outpatient Clinic collaborate with the school system and the other health care providers in _ Indian River County to provide clinical and consultative services . Parenting Education Group is an education and discussion group for parents and children with psychiatric disorders and/or behavioral problems . A licensed therapist who has experience with this identified group will facilitate this group . During the fiscal year 2004/2005 , 30 (five 6-week cycles) parenting education classes were held . These classes were attended by parents and extended family members providing care for children. 5 EXHIBIT A (Copy of complete Request for Proposal ) EXHIBIT - A - The Center for Emotional and Behavioral Health@IRM H — Parenting Education Group — IRC - CSAC Be PROGRAM NEED STATEMENT (Entire Section B not to exceed one page) 1 . a) What is the unacceptable condition requiring change ? b) Who has the need ? c) Where do they live ? d) Provide local, state, or national trend data, with reference source, that corroborates that this is an area of need. , Children diagnosed with psychiatric disorders or who have problematic behavioral problems do not always respond to conventional parenting approaches. Usually a more sophisticated parenting approach is required to better manage these children. These new parenting skills improve the behavior of the children and reduce the distress in the family. The Parenting Education Group provides this skill . This type of parenting group is lacking in Indian River County. According to a national survey titled Speaking of Kids ( 199 lb) reports that a majority of American adults, regardless of age, race, marital, or parental status believe that it is harder to be a parent today than it used to be (88 percent) and that parents today often are uncertain about what is the right thing to do in raising their children (86 percent) . Therefore based on this alarming statistic, parent education groups would be an asset for the parents of Indian River County. Furthermore, an estimated 12- 15 % of all children suffer mental disorders; approximately 10% have received treatment in the past year (National Commission on Children, 1991 a) . Nearly 500,000 American children now live in hospitals, detention facilities, and foster homes. That number is expected to climb to more than 840,000 by 1995 (House Select Committee on Children, Youth and Families, 1989) In the United States, approximately 1 . 3 million people are in the State and Federal prisons and 4 . 6 million people are under correctional supervision in the community. About 7% of all incarcerated people have serious mental illness, and a much higher percentage have less serious forms of mental illness. People with mental illness who come in contact with the criminal justice system are often poor, uninsured, disproportionately members of minority groups, homeless, and living with co-occurring substance abuse and mental disorders . They are likely to continually recycle through the mental health, substance abuse and criminal justice system. According to the Bureau of Justice Statistics (2002), women are a dramatically growing presence in all parts of the criminal justice system . Current statistics reveal that women comprise 11 % of the total jail population, 6% of prison inmates, 22% of adult probationers , and 12% of parolees. Many women entering jails have been victims of violence and present multiple problems in addition to mental health and substance abuse disorders, including child-rearing and parenting difficulties, health problems, and histories of violence, sexual abuse, and trauma. Gender-specific services and gender-responsive programs are in increasing demand but are rarely present in correctional facilities designed for men. Early needs assessment, screening for mental and substance abuse disorders, and identification of other needs relating to self or family are critical to effectively plan treatment for incarcerated women. Indian River Countyj ail currently has 629 prisoners of which 540 or 86% are men and 85 or 14% are women. Of this, 187 men and 33 women are sentenced felons and misdemeanants. All these 220 people are sentenced anywhere from a month to 12 months and will be released into the community. These inmates awaiting re-entry programs, need to be equipped with necessary skills to lead productive lives as responsible citizens . Both men and women lack adequate parenting skills and problem solving and life skills . Providing parenting education classes addressing their unique needs will help these men and women become more positive role models for their children. This will enable us to be one step closer to violence prevention and youth violence prevention. a) Identify similar programs that are currently serving the needs of your targeted population; b) Explain how these existing programs are under-serving the targeted population of your program. Although there are other parenting groups in Indian River County, none offer the clinical expertise and education to parents of children that have psychiatric and/or behavior problems that we are aware of. No parenting classes are available for inmates now. 6 'Me Center for Emotional and Behavioral Health@IRMH - Parenting Education Group - IRC - CSAC C. PROGRAM DESCRIPTION (Entire Section C. 1 — 6, not to exceed two pages) 1 . List Priority Needs area addressed. Therapeutic intervention and education Parenting Education Group program for parents of children and adolescents with emotional problems in Indian River County, 2 . Briefly describe program activities including location of services . The program helps the parent to identify their parenting style : easy going, rescuer, disciplinarian or consultant. All of these styles are detrimental to the child except for the consultant—the style the parent will embrace after attending the group. The parents learn effective ways of providing choices, the difference between using thinking words versus fighting words . They will learn how to avoid control battles with their children and the importance of giving the children age appropriate responsibility. The parents learn new skills and follow simple but powerful models that enable the child to become more skilled at making decision and behaving more appropriately. The educational component is provided via a lecture for 30 minutes followed by discussion related to a specific problem parents may be having with their children. The Parenting Education Group meets at the Center for Emotional and Behavioral Health and at the Indian River County jail . 3 . Briefly describe how your program addresses the stated need/problem. Describe how your program follows a recognized "best practice" (see definition on page 12 of the Instructions) and provide evidence that indicates proposed strategies are effective with target population . The material for this Parenting Education Group is based on two of the most effective parenting modes available today. They are the Love and Logic method developed by Jim Fay and Foster W. Cline, MD and The Systematic Training for Effective Parenting (STEP) model developed by Don Dinkmeyer and Gary McKay. Both of these models provide excellent, easy to understand techniques for parents that will reduce conflict with their child. The goal is to promote parenting expertise in each parent who attends this group. 7 The Center for Emotional and Behavioral Health@IRMH — Parenting Education Group — IRC - CSAC PROGRAM COVER PAGE Organization Name : The Center for Emotional and Behavioral Health @ IRMH Director: Mariamma Pyngolil, RN E-mail : mariamma.pynggliPirmh. org Address : 1190 37th Street Telephone: 772-563 -466 , Ext . 1838 Vero Beach, FL 32960 Fax : 772-770-2025 Program Director: Andrew Dobo, PSy.D . E-mail : andrew.dobona irmh. org Address : 1190 37th Street Telephone : 772-563 -4666 , Ext. 1878 Vero Beach FL 32960 Fax : 772-770-2025 j a0 g Pro ra Title: Parenting Education's roup Priority ea Addresse is intervention and educatnal Parentin Education Group Program for parents, children and adolescents with emotional problems in Indian River County. Brief Description of the Program : PH-610 Parenting Education : Programs that provide classes, groups or other educational opportunities for parents who want to acquire the knowledge and skills to be effective in their parenting role. PH-610 . 680 Parenting Skills Development: Programs that teach skills that enable parents to deal constructively and consistently with a broad spectrum of child rearing problems which may include sibling rivalry; school behavior and performance; poor self-esteem; shyness ; drug use; sexual promiscuity; and the whole range of negative acting out behaviors including whining temper tantrums, disobedience, insolence and destructiveness. Some parenting skill development programs utilize a step-by-step approach for managing specific problems and may incorporate application at home of techniques that were discussed and practiced in the classroom setting. Other programs may offer participatory family workshops, which provide opportunities for parents and children to learn and practice methods for dealing with one another in the guidance of a trained facilitator. Most training programs teach the parent a particular way of talking and relating to their children that reinforces positive behaviors and communication and decrease negative behaviors while supporting the development of a relationship that is built on fairness, mutual caring and respect. 3 The Center for Emotional and Behavioral Health@IRMH — Parenting Education Group — IRC - CSAC 4. List staffmg needed for your program, including required experience and estimated hours per week in program for each staff member and/or volunteers (this section should conform- with the information in the Position Listing on the Budget Narrative Worksheet). One licensed therapist for 4 hours per week for CEBH and one licensed therapist for 4 hours per week for the jail program. This includes group preparation, advertising activities, outreach to promote the group and facilitating the weekly one hour Parenting Education Group. 5. How will the target population be made aware of the program? Target population for the parenting education group will be made aware of the group by referrals from the Center for Emotional and Behavioral Health in-patient and outpatient therapists and physicians . Flyers will be distributed in the community via the Vero Beach Community Health Fair, distribution to Indian River County Schools via school specialists . The group will be advertised in the Indian River Memorial Hospital calendar published in the Vero Beach Press Journal, as well as on the web and the Hospital Newsletter. The inmates will be informed of the classes through the Re-entry Program Coordinator. 6 . How will the program be accessible to target population (i.e., location, transportation, hours of operation) ? The Parenting Education Group is located at the Center for Emotional and Behavioral Health across the street from Indian River Memorial Hospital and easily accessible for US 1 or Indian River Blvd . The group will meet for one hour once a week in the evening. Parents must provide — their own transportation to get to and from the group. The parenting education for the inmates will be provided at the County jail . The Re-entry Program Coordinator will select participants and facilitate their attendance. 8 The Center for Emotional and Behavioral Health@IRM H — Parenting Education Group — IRC - CSAC D . MEASURABLE OUTCOMES (Description of Intent) Use the Measurable Outcomes form. This descn* [ion Lqge does not need to be included in the proposal. In order to show the impact that your program is having on the target population and the community, the funders are requiring measurable outcomes . Please review the examples and summaries below to insure your understanding of what is expected. OUTCOMES : Describes what you want to achieve with the target population. Indicates the results of the services you provide, not the services you provide. Outcomes utilize action words such as maintain, increase, decrease, reduce, improve, raise and lower. ACTIVITIES : Describes the tasks that will be accomplished in the program to achieve the results stated in the outcomes . Activities utilize action words such as complete, establish, create, provide, operate, and develop. The activities should reflect the services described in the PROGRAM DESCRIPTION (C2) . Use the following elements to develop your outcomes. All elements must be included: • Direction of change • Time frame • Area of change • As measured by • Target population • Baseline: The number that you will be • Degree of chane measuring against Example 1 (Outcome) : To decrease (direction of change) number of unexcused absences (area of change) of enrolled boys and girls (target population) by 75 % (degree of change) in one year (time frame) as reported by the 2003 School Board attendance records (as measured by). Baseline : 2003 School Board attendance records for enrolled boys and girls. Example 1 (Activity) : To provide anger management classes to enrolled boys and girls 2 times a week for 12 weeks . Example 2 (Outcome) : 75 % (degree of change) of youth (target population) who have participated in the academic enrichment activities (as measured by) for 6 months or more (timeframe), will improve (direction of change) their scores in one or more subject area (area of change) . 25 % of participants in academic enrichment activities will maintain the initial level of performance assessed at entry. Baseline : Pre-test scores from the academic enrichment test. Example 2 (Activity) : 1 ) Provide pre and post-test exercises on the Advanced Learning System software; 2) Participants will go through the one lesson per week and be graded for 10 weeks . IMPORTANT NOTE • Keep in mind when developing your PROGRAM OUTCOMES , that if funded, this will be what you are held accountable to accomplish. Also, the PROGRAM OUTCOMES should reflect the information described in the PROGRAM NEED STATEMENT (B1 ). All Program Need Statements should flow from the Mission & Vision. Measurable Outcomes should be based on and measure program needs. Activities are the tasks you do that are going to influence the outcome and impact the unacceptable condition in your Program Need Statement. 9 The Center for Emotional and Behavioral Health@IRMH — Parenting Education Group — IRC - CSAC SUMMARY REPORT — (Enter Information In The Black Cells On Amount Requested from Funder for 2005 / 06 $ 9 , 657 . 42 Total Proposed Program Budget for 2005 / 06 $ , 2 Percent of Total Program Budget : 67 . 2 % Current Program Funding ( 2004 / 05 ) : $ 51000 Dollar increase / ( decrease ) in request : $ 4 , 657 Percent increase / ( decrease ) in request * * : 93 . 1 % Unduplicated Number of Children to be served Individually : 125 Unduplicated Number of Adults to be served Individually : _ Unduplicated Number to be served via Group settings : _ Total Program Cost per Client : 114 . 96 * *If request increased 5 % or more, briefly explain why: Adding a new program for the inmates . Increase in wages. If these funds are being used to match another source, name the source and the $ amount : The Organization 's Board of Directors he approv�kthis application onldateJ4 jj O �+ihr � es S heyN Name of President/Chair of the Board Sig4ature Name of Executive D ' ctor/CEO 4 The Center for Emotional and Behavioral Health@IRMH — Parenting Education Group — IRC - CSAC PROPOSAL NARRATIVE A . ORGANIZATION CAPABILITY (Entire Section A not to exceed one page) 1 . Provide the mission statement and vision of your organization. Indian River Memorial Hospital strives to be the finest community based health care organization anywhere. Our values are compassion, respect, and teamwork. The Center for Emotional and Behavioral Health A IRMH is committed to provide excellence in Mental Health Care to the individual and families while responding to the needs of the changing community. Our patients can expect quality care with dignity and professionalism through the collaborative efforts of the multidisciplinary team. We will continue to support the Quality First process while working together as a team. Parenting Education Group is committed to improving lives of children and their families who are challenged by psychiatric disorders and/or behavioral problems by teaching and promoting effective parenting skills . 2 . Provide a brief summary of your organization including areas of expertise, accomplishments, and population served. CEBH is the only Baker Act receiving facility for Indian River County and the only one for children and adolescents for all of the Treasure Coast. CEBH provides behavioral health care services to children, adolescents and adults . The services include: ( 1 ) Assessment and Referral Services, (2) Inpatient Services, (3) Outpatient Services for Children and Adolescents and (4) Community Outreach. Assessment and Referral Services provides psychiatric assessment and placement in appropriate level of care 24 hours a day, 7 days a week. The services are offered to anyone seeking help in a behavioral or emotional crisis . Inpatient Services provide short-term acute care and crisis stabilization for all patients who cannot be safely managed in an outpatient setting. Inpatient services are provided on a voluntary or involuntary basis, to all three age groups . The Outpatient Services provide psychiatric and mental health care for about 388 children and adolescents . A board eligible psychiatrist trained in child and adolescent needs and unique developmental characteristics provides psychiatric care which includes comprehensive evaluations, treatment planning and medication management. Masters and doctoral level prepared therapists provide psychotherapy and counseling services to children, adolescents , and their families to enable them to cope with the emotional and behavioral issues . The outpatient services also include a summer camp (Camp Manatee Therapeutic Summer Camp) for ADHD children, experiential (ROPES teambuilding) , parenting classes, group therapy for children and adolescents, urine drug screens/drug free workplace services, and community outreach. The children receiving services range from 3 to 18 years of age. This program has demonstrated success in providing early intervention for children suffering from any emotional, behavioral disorder or acute and traumatic stress. This program also helps to maintain the children in the natural environment, thus preventing acute care hospitalization. The medical director and staff of the Outpatient Clinic collaborate with the school system and the other health care providers in _ Indian River County to provide clinical and consultative services . Parenting Education Group is an education and discussion group for parents and children with psychiatric disorders and/or behavioral problems . A licensed therapist who has experience with this identified group will facilitate this group . During the fiscal year 2004/2005 , 30 (five 6-week cycles) parenting education classes were held . These classes were attended by parents and extended family members providing care for children. 5 The Center for Emotional and Behavioral Health@IRMH — Parenting Education Group — IRC - CSAC D . MEASURABLE OUTCOMES (Entire Section D not to exceed two pages) OUTCOMES ACTIVITIES Add all of the elements for the Measurable Outcome(s) Add the tasks to accomplish the Outcome(s) Ninety percent of participants will report an Instruct and provide six one-hour sessions, increase in their overall understanding of continuous series, of educational strategies so effective parenting strategies as reported on the that parents can better manage the behaviors of parenting post education evaluation form. their children. Baseline: Pre-class evaluation assessment. Ninety percent of the participants will report an Instruct and provide six one-hour sessions I ncrease in their overall understanding of each, for men and women in the jail, effective parenting strategies as reported on the continuous series, offering education strategies parenting post education evaluation form. so that parents an better manage the behaviors of their children when they return to the home. Baseline: Pre-class evaluation assessment 10 The Center for Emotional and Behavioral Health@IRM H — Parenting Education Group — IRC - CSAC E. COLLABORATION (Entire Section E not to exceed one page) 1 . List your program's collaborative partners and the resources that they are providing to the program beyond referrals and support. (See individual funder requirements for inclusion of collaborative a reement letters.) Collaborative Agency Resources provided to the program Indian River Memorial Hospital and Provides physical plant for the Parenting Education Center for Emotional and Behavioral Group as well as consultation with psychiatric and Health psychological team members . Florida Institute of Technology Doctoral Practicum students assist with development of pre and post parent evaluation forms, and research of disorders and treatment modalities Department of Children and Families Provide consultation and follow-through for continuum of care. Indian River County School District Provide consultation and follow-through for continuum of care IRC Sheriff' s Office Provides venue for class and facilitate attendance 11 The Center for Emotional and Behavioral Health@IRM H — Parenting Education Group — IRC - CSAC Be PROGRAM NEED STATEMENT (Entire Section B not to exceed one page) 1 . a) What is the unacceptable condition requiring change ? b) Who has the need ? c) Where do they live ? d) Provide local, state, or national trend data, with reference source, that corroborates that this is an area of need. , Children diagnosed with psychiatric disorders or who have problematic behavioral problems do not always respond to conventional parenting approaches. Usually a more sophisticated parenting approach is required to better manage these children. These new parenting skills improve the behavior of the children and reduce the distress in the family. The Parenting Education Group provides this skill . This type of parenting group is lacking in Indian River County. According to a national survey titled Speaking of Kids ( 199 lb) reports that a majority of American adults, regardless of age, race, marital, or parental status believe that it is harder to be a parent today than it used to be (88 percent) and that parents today often are uncertain about what is the right thing to do in raising their children (86 percent) . Therefore based on this alarming statistic, parent education groups would be an asset for the parents of Indian River County. Furthermore, an estimated 12- 15 % of all children suffer mental disorders; approximately 10% have received treatment in the past year (National Commission on Children, 1991 a) . Nearly 500,000 American children now live in hospitals, detention facilities, and foster homes. That number is expected to climb to more than 840,000 by 1995 (House Select Committee on Children, Youth and Families, 1989) In the United States, approximately 1 . 3 million people are in the State and Federal prisons and 4 . 6 million people are under correctional supervision in the community. About 7% of all incarcerated people have serious mental illness, and a much higher percentage have less serious forms of mental illness. People with mental illness who come in contact with the criminal justice system are often poor, uninsured, disproportionately members of minority groups, homeless, and living with co-occurring substance abuse and mental disorders . They are likely to continually recycle through the mental health, substance abuse and criminal justice system. According to the Bureau of Justice Statistics (2002), women are a dramatically growing presence in all parts of the criminal justice system . Current statistics reveal that women comprise 11 % of the total jail population, 6% of prison inmates, 22% of adult probationers , and 12% of parolees. Many women entering jails have been victims of violence and present multiple problems in addition to mental health and substance abuse disorders, including child-rearing and parenting difficulties, health problems, and histories of violence, sexual abuse, and trauma. Gender-specific services and gender-responsive programs are in increasing demand but are rarely present in correctional facilities designed for men. Early needs assessment, screening for mental and substance abuse disorders, and identification of other needs relating to self or family are critical to effectively plan treatment for incarcerated women. Indian River Countyj ail currently has 629 prisoners of which 540 or 86% are men and 85 or 14% are women. Of this, 187 men and 33 women are sentenced felons and misdemeanants. All these 220 people are sentenced anywhere from a month to 12 months and will be released into the community. These inmates awaiting re-entry programs, need to be equipped with necessary skills to lead productive lives as responsible citizens . Both men and women lack adequate parenting skills and problem solving and life skills . Providing parenting education classes addressing their unique needs will help these men and women become more positive role models for their children. This will enable us to be one step closer to violence prevention and youth violence prevention. a) Identify similar programs that are currently serving the needs of your targeted population; b) Explain how these existing programs are under-serving the targeted population of your program. Although there are other parenting groups in Indian River County, none offer the clinical expertise and education to parents of children that have psychiatric and/or behavior problems that we are aware of. No parenting classes are available for inmates now. 6 'Me Center for Emotional and Behavioral Health@IRMH - Parenting Education Group - IRC - CSAC C. PROGRAM DESCRIPTION (Entire Section C. 1 — 6, not to exceed two pages) 1 . List Priority Needs area addressed. Therapeutic intervention and education Parenting Education Group program for parents of children and adolescents with emotional problems in Indian River County, 2 . Briefly describe program activities including location of services . The program helps the parent to identify their parenting style : easy going, rescuer, disciplinarian or consultant. All of these styles are detrimental to the child except for the consultant—the style the parent will embrace after attending the group. The parents learn effective ways of providing choices, the difference between using thinking words versus fighting words . They will learn how to avoid control battles with their children and the importance of giving the children age appropriate responsibility. The parents learn new skills and follow simple but powerful models that enable the child to become more skilled at making decision and behaving more appropriately. The educational component is provided via a lecture for 30 minutes followed by discussion related to a specific problem parents may be having with their children. The Parenting Education Group meets at the Center for Emotional and Behavioral Health and at the Indian River County jail . 3 . Briefly describe how your program addresses the stated need/problem. Describe how your program follows a recognized "best practice" (see definition on page 12 of the Instructions) and provide evidence that indicates proposed strategies are effective with target population . The material for this Parenting Education Group is based on two of the most effective parenting modes available today. They are the Love and Logic method developed by Jim Fay and Foster W. Cline, MD and The Systematic Training for Effective Parenting (STEP) model developed by Don Dinkmeyer and Gary McKay. Both of these models provide excellent, easy to understand techniques for parents that will reduce conflict with their child. The goal is to promote parenting expertise in each parent who attends this group. 7 The Center for Emotional and Behavioral Health@IRM H — Parenting Education Group — IRC - CSAC F. PROGRAM EVALUATION (Entire Section F not to exceed two pages) 1 . DEMOGRAPHICS : What information (data elements) will you need to collect in order to accurately describe your target population including demographics (age, gender, and ethnic background) required by the funder in Section H? What are the pieces of information that qualify them for your target population? How do you document their need for services or their "unacceptable condition requirin • change" from Secti gon Bl ? We will track the following demographics as provided by the parents via the registration form : ❖ Age ❖ Gender ❖ Ages of children ••• Zip code Center for Emotional and Behavioral Health outpatient therapists ' will collaborate with community mental health agencies and Student Support Specialist to identify potential parents who may need these parenting classes to learn effective ways and strategies to parent a child with a psychiatric disorder 2 . MEASURES : What data elements will you need to collect to show that you have achieved (or made progress toward) your Measurable Outcomes in Section D ? What tools or items are you using as measures (grades, survey scores, attendance, absences, skill levels) for your program? Are you getting baseline information from a source on your Collaboration List in Section E? Are there results from your Activities in Section D that need to be documented? How often do you need to collect or follow-up on this data? We will be taking attendance each week to count the number of participants . We will be distributing a pre and post evaluation for each six-week parenting class to measure parent effectiveness of strategies learned. This data then will be entered into a database for tracking purposes and to accurately measure goals and outcomes of our interventions and education. 3 . REPORTING: What will you do with this information to show that change has occurred? How will you use or present these results to the consumer, the funder, the program, and the community? How will you use this information to improve your program? The pre and post evaluations will be entered into a database and the outcomes will be charted and measured. We will keep all returned feedback evaluations for one year, to reference as needed . The results will guide curriculum and discussions in future groups 12 The Center for Emotional and Behavioral Health@IRMH — Parenting Education Group — IRC - CSAC G. TIMETABLE (Section G not to exceed one page) 1 . List the major action steps, activities, or cycles of events that will occur within the program year. New programs should include any start-up planning that may occur outside the funding year. In completing the timetable, review information detailed in prior sections. Month/Period Activities August/September 1 . Marketing/develop and mail flyers notifying potential 2005 parents/participants, school professionals, and community mental health professionals of the first group session. Advertise in Vero Beach Press Journal-"IRMH Educational Happenings", develop the Parenting Curriculum tailoring in to the needs of these group members, Compile goals of parents and determine outcomes October 2005 2 . Initial group meeting begins, Give parents pre-test evaluation form, November 2005and compile goals and chart data, initial group curriculum based on parent ' s need. Continue meeting for 6 weeks. November 2005 3 . Compile post test data evaluation information, compile outcomes December 2005 - Repeat above steps 1 -3 based on six week Parenting Education Group September 2006 interval . September 2006 Compile all data from each Parenting Education Group interval and Wrap up group information for grant information (employee paycheck, cancelled checks, finance department) . 13 The Center for Emotional and Behavioral Health@IRMH — Parenting Education Group — IRC - CSAC 4. List staffmg needed for your program, including required experience and estimated hours per week in program for each staff member and/or volunteers (this section should conform- with the information in the Position Listing on the Budget Narrative Worksheet). One licensed therapist for 4 hours per week for CEBH and one licensed therapist for 4 hours per week for the jail program. This includes group preparation, advertising activities, outreach to promote the group and facilitating the weekly one hour Parenting Education Group. 5. How will the target population be made aware of the program? Target population for the parenting education group will be made aware of the group by referrals from the Center for Emotional and Behavioral Health in-patient and outpatient therapists and physicians . Flyers will be distributed in the community via the Vero Beach Community Health Fair, distribution to Indian River County Schools via school specialists . The group will be advertised in the Indian River Memorial Hospital calendar published in the Vero Beach Press Journal, as well as on the web and the Hospital Newsletter. The inmates will be informed of the classes through the Re-entry Program Coordinator. 6 . How will the program be accessible to target population (i.e., location, transportation, hours of operation) ? The Parenting Education Group is located at the Center for Emotional and Behavioral Health across the street from Indian River Memorial Hospital and easily accessible for US 1 or Indian River Blvd . The group will meet for one hour once a week in the evening. Parents must provide — their own transportation to get to and from the group. The parenting education for the inmates will be provided at the County jail . The Re-entry Program Coordinator will select participants and facilitate their attendance. 8 The Center for Emotional and Behavioral Health@IRM H — Parenting Education Group — IRC - CSAC D . MEASURABLE OUTCOMES (Description of Intent) Use the Measurable Outcomes form. This descn* [ion Lqge does not need to be included in the proposal. In order to show the impact that your program is having on the target population and the community, the funders are requiring measurable outcomes . Please review the examples and summaries below to insure your understanding of what is expected. OUTCOMES : Describes what you want to achieve with the target population. Indicates the results of the services you provide, not the services you provide. Outcomes utilize action words such as maintain, increase, decrease, reduce, improve, raise and lower. ACTIVITIES : Describes the tasks that will be accomplished in the program to achieve the results stated in the outcomes . Activities utilize action words such as complete, establish, create, provide, operate, and develop. The activities should reflect the services described in the PROGRAM DESCRIPTION (C2) . Use the following elements to develop your outcomes. All elements must be included: • Direction of change • Time frame • Area of change • As measured by • Target population • Baseline: The number that you will be • Degree of chane measuring against Example 1 (Outcome) : To decrease (direction of change) number of unexcused absences (area of change) of enrolled boys and girls (target population) by 75 % (degree of change) in one year (time frame) as reported by the 2003 School Board attendance records (as measured by). Baseline : 2003 School Board attendance records for enrolled boys and girls. Example 1 (Activity) : To provide anger management classes to enrolled boys and girls 2 times a week for 12 weeks . Example 2 (Outcome) : 75 % (degree of change) of youth (target population) who have participated in the academic enrichment activities (as measured by) for 6 months or more (timeframe), will improve (direction of change) their scores in one or more subject area (area of change) . 25 % of participants in academic enrichment activities will maintain the initial level of performance assessed at entry. Baseline : Pre-test scores from the academic enrichment test. Example 2 (Activity) : 1 ) Provide pre and post-test exercises on the Advanced Learning System software; 2) Participants will go through the one lesson per week and be graded for 10 weeks . IMPORTANT NOTE • Keep in mind when developing your PROGRAM OUTCOMES , that if funded, this will be what you are held accountable to accomplish. Also, the PROGRAM OUTCOMES should reflect the information described in the PROGRAM NEED STATEMENT (B1 ). All Program Need Statements should flow from the Mission & Vision. Measurable Outcomes should be based on and measure program needs. Activities are the tasks you do that are going to influence the outcome and impact the unacceptable condition in your Program Need Statement. 9 Number of Unduplicated Clients by Location Current F iscal Year Location ".. ��-� , � Ifilk�, - I�I� z Budget 2I I 4 1 1 1i MIMI 1 1 1 1 I I I 1 1 . • • 11 -- — 110FOIFOlol MIAMI MartinC1 Total ' Port -St. Lucie 1Total Other Locations _ i a 1 . Numberof Unduplicated Clients 1 ' t 1 1 I �' ° t �� j-��a �,��'� ;'�lil;� � : 1 � • 1 I � 1 �� `��el �� I �� . �� €� d @4 } t..�s - i i`3 `� P � � 11 1 ` 1 1 � g�"g 1 . A 1 . . 5 to 10 - (Elementary) Total . , Edit this Header. Type the organization and program name and the funder for whom it is being completed. The page # is already set at the bottom right of every page. I. BUDGET FORMS - To open the Budget Forms, please double-click on the icon below. % I "Core Budget Forms " 15 The Center for Emotional and Behavioral Health@IRMH — Parenting Education Group — IRC - CSAC D . MEASURABLE OUTCOMES (Entire Section D not to exceed two pages) OUTCOMES ACTIVITIES Add all of the elements for the Measurable Outcome(s) Add the tasks to accomplish the Outcome(s) Ninety percent of participants will report an Instruct and provide six one-hour sessions, increase in their overall understanding of continuous series, of educational strategies so effective parenting strategies as reported on the that parents can better manage the behaviors of parenting post education evaluation form. their children. Baseline: Pre-class evaluation assessment. Ninety percent of the participants will report an Instruct and provide six one-hour sessions I ncrease in their overall understanding of each, for men and women in the jail, effective parenting strategies as reported on the continuous series, offering education strategies parenting post education evaluation form. so that parents an better manage the behaviors of their children when they return to the home. Baseline: Pre-class evaluation assessment 10 The Center for Emotional and Behavioral Health@IRM H — Parenting Education Group — IRC - CSAC E. COLLABORATION (Entire Section E not to exceed one page) 1 . List your program's collaborative partners and the resources that they are providing to the program beyond referrals and support. (See individual funder requirements for inclusion of collaborative a reement letters.) Collaborative Agency Resources provided to the program Indian River Memorial Hospital and Provides physical plant for the Parenting Education Center for Emotional and Behavioral Group as well as consultation with psychiatric and Health psychological team members . Florida Institute of Technology Doctoral Practicum students assist with development of pre and post parent evaluation forms, and research of disorders and treatment modalities Department of Children and Families Provide consultation and follow-through for continuum of care. Indian River County School District Provide consultation and follow-through for continuum of care IRC Sheriff' s Office Provides venue for class and facilitate attendance 11 Center for Ertwtional & Behavioral HeaMN Parenting Class UNIFORM GRANT APPLICATION BUDGET NARRATIVE WORKSHEET IMPORTANT: The Budget Narrative should provide details to justify the amount requested in each line item of the budget for your program. From this worksheet, your figures will be linked to the Total Agency Budget, Total Program Budget and Funder Specific Budget Forms. AGENCY/PROGRAM NAME : Center for Emotional & Behavorial Health/ Parenting Class FUNDER : IRC -CSAC CAUTION : Do not .enter any figures where a cell is colored in dark blue = Formulas and/or links are in place. - Gray areas should be used for calculations and to write information only. , REVENUESow`r . Pr�Pos rogr =t)nt 1 Children's Services CouncilSt Lucie 2 Children's Services Council- Martin 3 Advisory Committee-Indian River 99657.42 907.42 167,818.1 4 United Wa St Lucie County 5 United Way-Martin County 6 United Way-Indian River County 7 Department of. Children & Families 8 County Funds 9 Contributions-Cash 10 Program Fees . 79300,000.00 11 Fund Raising Events-Net 12 Sales to Public - Net 13 Membership Dues 14 Investment Income 15 Miscellaneous 16 Legacies b Bequests 2,000.00 17 Funds from Other Sources 18 Reserve Funds Used for.Operating 19 In-Kind Donations - IRMH 41712.50 20 TOTAL REVENUES " ` (do"n't include lir 19 $99657.42 $9,657.4 $7;469,818. 1 EXPENDITURES A Proposed Tofigfe gram 6RM!ME" FOIL AOEMOY USE ONLY > ' - ° - *,edi s . x x a m - x PHOW ALwLA Budget: _ . .... .., a . ,_ ' r - ... . r£ .✓ . ._ . . : . : > ra 21 Salaries - (must complete chart o'n next page' 6,921 .60 67921 . 4,2021409.27 ✓ L � .p , AF £ yq - , „ q ;_. fir Salary 22 FICA - Total salaries x 0.0765 715% 529.50 529.50 321 ,484.31 e semen - Annual pension r qua 23 staff I 3.92% 174.42 174.4 164*734.44 UWHealth - e Hca n o - rm 24 Disab. 13.27% 590,46 590.46 557,659.71 ;employ;ees ompensa Qn - employees x 25 1 .66 73.86 73. 69,759. . nmp oymen - prol 26x $7,000 x UCT-6 rate 0.17 7,56 7, 7, 144.10 5/17x2005 B-1 R R • Center for Emotional 8 Behavioral Health Parenting Class SALARIES A e n Gross Annual Portion o/ Salary on Pro C % of Grgss Annual POSITION LISTING Salary Funder Specific BUdget Salary Positron Title / TotarHrshvk (Agency,) Program Requested(C/A} trample Executrve D nxtor/a0 hrs : 70,000,00 10,000;00. : 5;000 00, ,` 714, Psychologist Licensed/24 hrs 34JO6.88 41449.60 4,449.60 12.82% Therapist Licensed/8 hrs 10,712.00 29472.00 2,472.00 23.08° #DIV/0! #DIV/O! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIVro! . #DIV/01 MV/01 #DIV/01 #DIV/0! #DIV/O! #DIV/0! #DIV/0! #DIV/0! #DIV/0! Remaining positions throughout thea gency 41156,990.3 Total Salaries $4,202,409.2 $6,921 .601 U.921 .60 0. 160 ENE ' TS flETAIL a , (Fu�ti�t Speict � �trget Funder s c v Fix Specific iryc racy > esy woirer's Columnryryyyy;Q��n�}.yyy��t��i+pm/��n�y 22 to 27) � t (A z y) Hesnn Ind: p �z ►+P>� �r 3!t0 ►Ks , 5i000.00 342.30 20000 .�f10.00 . _ . . £ ' . _ •QO OfWN ( S Psychologist Licensed/24 hrs 4t449.601 340.39 174.42 590.46 73.86 7.56 11186.71 Therapist Licensed/8 hrs 2,472.00 189. 11 189.11 0 . . 0.01 0.00 � 0.00 0 0.001 0.00 0.00 0 0. 0.00 0.001 0 O.D01 0.0.0 0.0 0 0. 0.00 0. 0 0• 0.00 0. 0 0• 0.00 0. 0 0. 0.00 0. 0 0. 0.00 0. 0 0.001 0.00 0. 0 0-001 0.00 0. 0 0.001 0.00 1 0. 0 O.Oq 0.00 0. 0 0.001 0.00 O.00I 0 0.001 0.00 _. 0.001 0 0.00 0.00 0. 0 0.001 0.00 0. 0 0.001 0.001 . 0. Total Funder Request Fringe Benefits $6,921 . $529. $174.4 $590. $73. $7. 31 ,375.8 5/172005 B-1 The Center for Emotional and Behavioral Health@IRM H — Parenting Education Group — IRC - CSAC F. PROGRAM EVALUATION (Entire Section F not to exceed two pages) 1 . DEMOGRAPHICS : What information (data elements) will you need to collect in order to accurately describe your target population including demographics (age, gender, and ethnic background) required by the funder in Section H? What are the pieces of information that qualify them for your target population? How do you document their need for services or their "unacceptable condition requirin • change" from Secti gon Bl ? We will track the following demographics as provided by the parents via the registration form : ❖ Age ❖ Gender ❖ Ages of children ••• Zip code Center for Emotional and Behavioral Health outpatient therapists ' will collaborate with community mental health agencies and Student Support Specialist to identify potential parents who may need these parenting classes to learn effective ways and strategies to parent a child with a psychiatric disorder 2 . MEASURES : What data elements will you need to collect to show that you have achieved (or made progress toward) your Measurable Outcomes in Section D ? What tools or items are you using as measures (grades, survey scores, attendance, absences, skill levels) for your program? Are you getting baseline information from a source on your Collaboration List in Section E? Are there results from your Activities in Section D that need to be documented? How often do you need to collect or follow-up on this data? We will be taking attendance each week to count the number of participants . We will be distributing a pre and post evaluation for each six-week parenting class to measure parent effectiveness of strategies learned. This data then will be entered into a database for tracking purposes and to accurately measure goals and outcomes of our interventions and education. 3 . REPORTING: What will you do with this information to show that change has occurred? How will you use or present these results to the consumer, the funder, the program, and the community? How will you use this information to improve your program? The pre and post evaluations will be entered into a database and the outcomes will be charted and measured. We will keep all returned feedback evaluations for one year, to reference as needed . The results will guide curriculum and discussions in future groups 12 The Center for Emotional and Behavioral Health@IRMH — Parenting Education Group — IRC - CSAC G. TIMETABLE (Section G not to exceed one page) 1 . List the major action steps, activities, or cycles of events that will occur within the program year. New programs should include any start-up planning that may occur outside the funding year. In completing the timetable, review information detailed in prior sections. Month/Period Activities August/September 1 . Marketing/develop and mail flyers notifying potential 2005 parents/participants, school professionals, and community mental health professionals of the first group session. Advertise in Vero Beach Press Journal-"IRMH Educational Happenings", develop the Parenting Curriculum tailoring in to the needs of these group members, Compile goals of parents and determine outcomes October 2005 2 . Initial group meeting begins, Give parents pre-test evaluation form, November 2005and compile goals and chart data, initial group curriculum based on parent ' s need. Continue meeting for 6 weeks. November 2005 3 . Compile post test data evaluation information, compile outcomes December 2005 - Repeat above steps 1 -3 based on six week Parenting Education Group September 2006 interval . September 2006 Compile all data from each Parenting Education Group interval and Wrap up group information for grant information (employee paycheck, cancelled checks, finance department) . 13 . 1 ti 14, : �. r '.. It 1+! 3 O ^ Y � m : „ N >S "� l. : ) t. (^•! .,. .a. 1` 1)d3'; .Sw}¢�', h ':: O '1`V 1p`I wm OJIM 1 41.1 .., f W O O : N O O O '�• O `: O O k nl O µ „M ( p O sR dry O O ~. O O O N m Ir co LU � Y ti+JM Rt i y N 6 tl a y ^ ^ C4 ^ ~ y tgS � N V ^ I y N � �s TTOO•5� 46 x N _ $ N M F r 40 w � d HM !w � LL D. JV sTCjxj 2 y m U � Ea g `y�y�' F a� N !— w rIN c r UNIFORM GRANT APPLICATION TOTAL AGENCY BUDGET AGENCYIPROGRAM NAME:Center for Emotional & Behaviorial Health/ Parenting Class FY 0W/04 FY 0"S FY 05106 % INCREASE FYE_Nf30l2004 FYE_9W/M5 FYE_9/30!2006 CURRENTVS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (coL C-col. BycoL e REVENUES BUDGETED BUDGETED 1 Children's Services CouncilSt. Lucie 0.00 #DIV/O! 2 Children's Services Council-Martin 0.00 #DIV/OI 3 Advisory Committee-lndian River 20 000.00 24 445.00 167 818.13 586.51 % 4 United Way-St Lucie County0.00 #DIV/O! United Way-Martin County0100 #DIV/p! s United Way-Indian River Count0.00 #DIV/01 7 Department of Children & Families 0.00 #DIV/0! s CountyFunds 0.00 #DIV/O! 9 Contributions-Cash 0.00 #DIV/O! to Program Fees792249445.00 7 348 000. 7j3OOjOOO,OO 0,65% ii Fund Raising Events4*1: 0.00 #DIV/01 12 Sales to Public-Net 0.00 #DIV/0! 73 Membershi Dues 0.00 #DIV/01 14 Investment Income 0.00 #DIV/01 is Miscellaneous : 0.00 ODIV/0! 16 Legacies 8 Bequests 2 000.00 #DIV)01 17 Funds from Other Sources 0100 #DIV/01 16 Reserve Funds Used for Operating0.00 #DIV/O! 19 In-IQndDonations pmkwkwedin q 0.00 #Di1//01 TOTAL 79244s"5,00 7 37 445.001 746981813 1 .32% EXPENDITURES 21 Salaries 3,67do766,001 4 O80 009. 420 409.27 3.00% 22 FICA 259t962,001 293975&001 321484.31 9.44% 23 Retirement �1"J29,231 1592936,3M 164 734. 3,00% 24 LifeMealth 487 906. 54im417,191 557s659.71 3.00% 2s Workers Compensation 61034. 67 728.15 69j759.W 3.00% 26 Florida UnemploymentM 6 250. 6P936.02 7144.10 3.00% l-0a 27 Travel2g71OOOj 3 080.00 3172.40 3.00% 28 Travel/Conferences/Training 43r995,OOI 43,995 45,140,40 2.60% 29 Office Supplies. 50,219,001 44 529.0.0 529. . 6.00% Telephone 589.25 29 473.45 30 385.00 3.09% 37 Postage/Shipping4s499,0,0 Z922.00 69060,00 107.39% 32 Utilities 612.00 650000.00 70 200.00 8.00% 33 Occupancy (Building & Grounds 87 405. 8882981 891 320.81 0.26% m Printin & Publications 857.00 3,000.00 3120.00 4.00% 3s Subsarl bersh 317.00 5556.00 5556.00 . 0.00% 36 Insurance I �40%660,00 3759675,00 375 000. 00015% V EquipmentRental S Maintenance 14 029.00 172568, 17v5OO,OOj 0,39% Advertisin 50000,00 51000100 5000.00 0.00% 39 Equitunent Purchases:CapW Expense 11274.00 89647,00 9000.00 4.08% 40 Professional Fees CLegak Consulting) 287, 2289612,00 2289612.00 0.00% 41 BookslEducationai Materials 20 606.00 29 080.00 29 080.00 0.00% 42 Food & Nutrition 137 328.00 141 600. 118 038. -16.64% 43 Administrative Costs 424 365. 430 730.48 47Z795,75 9.77% Audit Fit 0.00 0.00 0.00 7fD11//O! 4s Specific Assistance to individuals 0.00 0.00 0.00 #1X1//0! 46 Other/Miseellaneous 800.00 800.00 1575.00 96.88% 47 OthedContract 871o908,00 87 000.00 87Z000,00 0.00% 4s TOTAL T 911509.1 89345928*64 8551276.18 2.46% ,�,� -_�. . � 49 REVENUES OVER/ UNDER EXPENDITURES -67 064.1 -973j483,64 -1 081 .458.05 11 .09% sn7rM Number of Unduplicated Clients by Location Current F iscal Year Location ".. ��-� , � Ifilk�, - I�I� z Budget 2I I 4 1 1 1i MIMI 1 1 1 1 I I I 1 1 . • • 11 -- — 110FOIFOlol MIAMI MartinC1 Total ' Port -St. Lucie 1Total Other Locations _ i a 1 . Numberof Unduplicated Clients 1 ' t 1 1 I �' ° t �� j-��a �,��'� ;'�lil;� � : 1 � • 1 I � 1 �� `��el �� I �� . �� €� d @4 } t..�s - i i`3 `� P � � 11 1 ` 1 1 � g�"g 1 . A 1 . . 5 to 10 - (Elementary) Total . , Edit this Header. Type the organization and program name and the funder for whom it is being completed. The page # is already set at the bottom right of every page. I. BUDGET FORMS - To open the Budget Forms, please double-click on the icon below. % I "Core Budget Forms " 15 CMw N Ewwtb YfD hs%4wWH WJ Pww" CWs UNIFORM GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME:Center for Emotional & Behaviorial Health/ Parenting Class 03104 FY 04105 FY OSM % INCREASE FYE_913W2W4 FYE_9/301 M FYE CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (Col. CtoL BpooL B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St Lucie 0.00 #DIV/0! 2 Children's Services Council-Martin 0.00 #DNPoI 3 Advisory Committee-Indian River 965742 #DIVPo! United Way-St. Lucie County0.00 #DIVAH s United Way-Martin County 0.00 #DIVPo! I; United Way-Indian River County0.00 #DNPo! 7 Department of Children S Families 0.00 #DIVPo! a CountyFunds 0.00 #DIV/Ot 9 Contributions-Cash 0.00 #DN/O! 10 Program Fees . 0.00 . #DIV/O! 11 Fund Raising Events-Net 0.00 #DNPo! 12 Sales tO Public-Net 0.00 #DIVAH 13 Membership Dues 0.00 tIDNPo! 14 Investment Income 0.00 #DIVPoI 1s Miscellaneous 0.00 ilpNPot is Legacies & Bequests 0.00 #DNPoI v Funds from Other Sources 0,00 #DNPo! 1B Reserve Funds Used for Operating 0.00 #DIVPoI i9 in4Qnd Donations (Na lnelj4.d In long 1837.50 . #DIVAN 20 TOTAL 0.00 . 0.00 99657,42 #DIVPo! EXPENDITURES 21 Salaries 6j921 ,60 #DIVPoI zx FICA 529.50 #DIVPo! 23 Retirement 174.42 #DIVPoI 24 LlfeAiealtir 590.46 #DIVAH 25 orkers CoMpgnsation 73.86 #DIVAH 26 Florida Unem ment . 7w56 mm, 27 Travel-Dai 0.00 #DIVPoI 2a TravoYConferences/Traini 0:00 #DIV/O! 2.9 Offic4supplies 210.00 #DIVPoI 3o T hone 100.00 #DIVAH31 P hi in 100.00 #DIVJOI 32 Utilities 300.00 #DNPoI 33. Occupancy (Building B Grounds 575.00 #DIVAH 34 Pri S Publications 50.00 #=/01 36 SubscripbontpuesnAemberships100.00 #WVPoI 36 Insurance 787.50 #DIVAH 37 E ui ent:Rentai 8-Maintenance 0.00 #DIVPoI. 38 Advertising0.00 #DIV/01 39 E4ulpment Purchase*:Capitid Expensem 0,00 #DNPo! 40 Professional Fees L 1 Consulting) 0.00 #DNPot 41 BOOkS/EduCational Materials 800.00 #DIV/0t 42 Food S Nutrition 0.00 #DIVAH 43 Administrative Costs 1050.00 #DNPoI 44 Audit Expense 0.00 #DIVAH 45 Specific Assistance to individuals0.00 #DIVPo! 46 Other/Miscellaneous 0.00 #DN/OI 47 OtheNContract 0.00 #DNroI 48 TOTAL 0.00 0.00 142369,92 #DIVAH 49 REVENUES OVER/ UNDER EXPENDITURES 0.00 0.001 .4 2712.50 #DNPoi. . �� ea I 1 Center for Emotional & Behavioral HealW Parenting Class UNIFORM GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/PROGRAM NAME : Center for Emotional & Behaviorial Health/Parenting Class FUNDER : IRC - CSAC A B C FY 05/06 FY 05/06 % OF TOTAL FUNDER TOTAL VS. PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET col. B/col. A) EXPENDITURES 21 Salaries 6,921 .60 6,921 .60 100.00% 22 FICA 529.50 529.50 100.00% 23 Retirement 174.42 174.42 100.000% 24 Life/Health 590.46 590.46 100.00% 25 Workers Compensation 73.86 73.86 100.00% 26 Florida Unemployment 7.56 7.56 100.00% 27 Travel-Dai 0.00 . 0.00 0DN/01 28 Travel/Conferences/Training 0.00 0.00 #DN/01 29 Office Su lies 210.00 210.00 100.00% 30 Telephone 100.00 100.00 100.00% 31 Postage/Shipping 100.00 100.00 100.00% 32 Utilities 300.00 0.00 0.00% 33 Occupancy` (Building & Grounds 2,575.00 0.00 0.00% 34 Printing & Publications 50.00 50.00 100.00% 35 Subscri tion/Dues/Membershi s 100.00 100.00 100.00% 36 Insurance. 787.50 0.00 0.00% 37 Eoui rnent: Rental & Maintenance 0.00 0.00 4DIV/01 38 Advertlsin 0.00 0.00 #DN/01 39 Equipment Purchases: Ca ital Expense 0.00 0.00 #DN/01 40 Professional Fees (Legal, Consulting) 0.00 0.00 #DN/0 ! 41 BookslEducatlonal Materials 800.00 800.00 100.00% 42 Food & Nutrition 0.00 0.00 9DN/01 43 Administrative Costs 11050.00 0.00 0.000/0 44 Audit Expense 0.00 0.00 #DN/0 ! 45 Specific Assistance to Individuals 0.00 0.00 #DN/01 46 Other/Miscellaneous 0.00 0.00 #DN/01 47 Other/Contract 0.00 0.00 #DN/0 ! 48 TOTAL $14,369.92 $9,657.42 67.21 % SPIMM E" Center for Ertwtional & Behavioral HeaMN Parenting Class UNIFORM GRANT APPLICATION BUDGET NARRATIVE WORKSHEET IMPORTANT: The Budget Narrative should provide details to justify the amount requested in each line item of the budget for your program. From this worksheet, your figures will be linked to the Total Agency Budget, Total Program Budget and Funder Specific Budget Forms. AGENCY/PROGRAM NAME : Center for Emotional & Behavorial Health/ Parenting Class FUNDER : IRC -CSAC CAUTION : Do not .enter any figures where a cell is colored in dark blue = Formulas and/or links are in place. - Gray areas should be used for calculations and to write information only. , REVENUESow`r . Pr�Pos rogr =t)nt 1 Children's Services CouncilSt Lucie 2 Children's Services Council- Martin 3 Advisory Committee-Indian River 99657.42 907.42 167,818.1 4 United Wa St Lucie County 5 United Way-Martin County 6 United Way-Indian River County 7 Department of. Children & Families 8 County Funds 9 Contributions-Cash 10 Program Fees . 79300,000.00 11 Fund Raising Events-Net 12 Sales to Public - Net 13 Membership Dues 14 Investment Income 15 Miscellaneous 16 Legacies b Bequests 2,000.00 17 Funds from Other Sources 18 Reserve Funds Used for.Operating 19 In-Kind Donations - IRMH 41712.50 20 TOTAL REVENUES " ` (do"n't include lir 19 $99657.42 $9,657.4 $7;469,818. 1 EXPENDITURES A Proposed Tofigfe gram 6RM!ME" FOIL AOEMOY USE ONLY > ' - ° - *,edi s . x x a m - x PHOW ALwLA Budget: _ . .... .., a . ,_ ' r - ... . r£ .✓ . ._ . . : . : > ra 21 Salaries - (must complete chart o'n next page' 6,921 .60 67921 . 4,2021409.27 ✓ L � .p , AF £ yq - , „ q ;_. fir Salary 22 FICA - Total salaries x 0.0765 715% 529.50 529.50 321 ,484.31 e semen - Annual pension r qua 23 staff I 3.92% 174.42 174.4 164*734.44 UWHealth - e Hca n o - rm 24 Disab. 13.27% 590,46 590.46 557,659.71 ;employ;ees ompensa Qn - employees x 25 1 .66 73.86 73. 69,759. . nmp oymen - prol 26x $7,000 x UCT-6 rate 0.17 7,56 7, 7, 144.10 5/17x2005 B-1 R R • Center for Emotional 8 Behavioral Health Parenting Class SALARIES A e n Gross Annual Portion o/ Salary on Pro C % of Grgss Annual POSITION LISTING Salary Funder Specific BUdget Salary Positron Title / TotarHrshvk (Agency,) Program Requested(C/A} trample Executrve D nxtor/a0 hrs : 70,000,00 10,000;00. : 5;000 00, ,` 714, Psychologist Licensed/24 hrs 34JO6.88 41449.60 4,449.60 12.82% Therapist Licensed/8 hrs 10,712.00 29472.00 2,472.00 23.08° #DIV/0! #DIV/O! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIVro! . #DIV/01 MV/01 #DIV/01 #DIV/0! #DIV/O! #DIV/0! #DIV/0! #DIV/0! #DIV/0! Remaining positions throughout thea gency 41156,990.3 Total Salaries $4,202,409.2 $6,921 .601 U.921 .60 0. 160 ENE ' TS flETAIL a , (Fu�ti�t Speict � �trget Funder s c v Fix Specific iryc racy > esy woirer's Columnryryyyy;Q��n�}.yyy��t��i+pm/��n�y 22 to 27) � t (A z y) Hesnn Ind: p �z ►+P>� �r 3!t0 ►Ks , 5i000.00 342.30 20000 .�f10.00 . _ . . £ ' . _ •QO OfWN ( S Psychologist Licensed/24 hrs 4t449.601 340.39 174.42 590.46 73.86 7.56 11186.71 Therapist Licensed/8 hrs 2,472.00 189. 11 189.11 0 . . 0.01 0.00 � 0.00 0 0.001 0.00 0.00 0 0. 0.00 0.001 0 O.D01 0.0.0 0.0 0 0. 0.00 0. 0 0• 0.00 0. 0 0• 0.00 0. 0 0. 0.00 0. 0 0. 0.00 0. 0 0.001 0.00 0. 0 0-001 0.00 0. 0 0.001 0.00 1 0. 0 O.Oq 0.00 0. 0 0.001 0.00 O.00I 0 0.001 0.00 _. 0.001 0 0.00 0.00 0. 0 0.001 0.00 0. 0 0.001 0.001 . 0. Total Funder Request Fringe Benefits $6,921 . $529. $174.4 $590. $73. $7. 31 ,375.8 5/172005 B-1 EXHIBIT B ( From policy adopted by Indian River County Board of county Commissioners on February 19 , 2002 ) " D . Nonprofit Agency Responsibilities After Award Funding Indian River County provides funding to all nonprofit agencies on a reimbursement basis only. All reimbursable expenses must be documented by an invoice and/or a copy of the canceled check . Any expense not documented properly to the satisfaction of the Office of Management & Budget and/or the County Administrator may not be reimbursed . If an agency repeatedly fails to provide adequate documentation , this may be reported to the Board of Commissioners . In the event an agency provides inadequate documentation on a consistent basis , funding may be discontinued immediately. Additionally, this may adversely affect future funding requests . Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For example , no expenditures prior to October 1St may be reimbursed with funds from the following year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not carried over to the next year unless expressly authorized by the Board of Commissioners . All requests for reimbursement at fiscal year and (September 30th) must be submitted on a timely basis . Each year, the Office of Management and Budget will send a letter to all nonprofit agencies advising of the deadline for reimbursement requests for the fiscal year. This deadline is typically early to mid October, since the Finance Department does not process checks for the prior fiscal year beyond that point. Each reimbursement request must include a summary of expense by type . These summaries should be broken down into salaries , benefit , supplies , contractual services , etc . If Indian River County is reimbursing an agency for only a portion of an expense (e . g . salary of an employee ), then the method for this portion should be disclosed on the summary. The Office of Management & Budget has summary forms available . Indian River County will not reimburse certain types of expenditures . These expenditure types are listed below. a ) Travel expenses for travel outside the County including but not limited to : mileage reimbursement, hotel rooms , meals , meal allowances , per diem , and tolls . Mileage reimbursement for local travel (within Indian River County) is allowable . b ) Sick or Vacation payments for employees . Since agencies may have various sick and vacation pay policies , these must be provided from other sources . c) Any expenses not associated with the provision of the program for which the County has awarded funding . d ) Any expense not outlined in the agency's funding application . The County reserves the right to decline reimbursement for any expense as deemed necessary. " EXHIBIT - B - EXHIBIT C STANDARD TERMS FOR GRANT CONTRACT 1 . Notices . Any notice , request, demand , consent, approval , or other communication required or permitted by this Contract shall be given , or made in writing , by any of the following methods : facsimile transmission ; hand delivery to the other party; delivery by commercial overnight courier service ; or mailed by registered or certified mail (postage prepaid ) , return receipt requested at the addresses of the parties shown below : County: Joyce Johnston-Carlson , Director Indian River County Human Services 184025 th Street Vero Beach , Florida 32960-3365 Recipient : CEBH - Center for Emotional & Behavioral Health 119037 th Street Vero Beach , Florida 32960 Attention : Mariamma Pyngolil , RN , Program Director 2 . Venue ; Choice of Law. The validity, interpretation , construction , and effect of this Contract shall be in accordance with and governed by the laws of the State of Florida only. The location for settlement of any and all claims , controversies , or disputes , arising out of or relating to any part of this Contract, or any breach hereof, as well as any litigation between the parties , shall be Indian River county, Florida for claims brought in state court, and the Southern District of Florida for those claims justifiable in federal court. 3 . Entirety of Agreement. This Contract incorporates and includes all prior and contemporaneous negotiations , correspondence , conversations , agreements , and understandings applicable to the matters contained herein and the parties agree that there are no commitments , agreements , or understandings concerning the subject matter of this Contract that are not contained herein . Accordingly, it is agreed that no deviation from the terms hereof shall be predicated upon any prior representations or agreements , whether oral or written . It is further agreed that no modification , amendment or alteration in the terms and conditions contained herein shall be effective unless contained in a written document signed by both parties . 4 . Severability. In the event any provision of this Contract is determined to be unenforceable or invalid , such unenforceability or invalidity shall not affect the remaining provisions of this Contract, and every other provision and term of this Contract shall be deemed valid and enforceable to the extent permitted by law. To that extent, this Contract is deemed severable . 5 . Captions and Interpretations . Captions in this Contract are included for convenience only and are not to be considered in any construction or interpretation of this Contract or any of its provisions . Unless context indicates otherwise , words importing the singular number include the plural number, and vise versa . Words of any gender include the correlative words of the other genders , unless the sense indicates otherwise . 6 . Independent Contractor. The Recipient is and shall be an independent contractor for all purposes under this Contract . The Recipient is not an agent or employee of the County, and any and all persons engaged in any of the services or activities funded in whole or in part performed pursuant to this Contract shall at all times and in all places be subject to the Recipient's sole direction , supervision and control . 7 . Assignment . This Contract may not be assigned by the Recipient without the prior written consent of the County. EXHIBIT - C - . 1 ti 14, : �. r '.. It 1+! 3 O ^ Y � m : „ N >S "� l. : ) t. (^•! .,. .a. 1` 1)d3'; .Sw}¢�', h ':: O '1`V 1p`I wm OJIM 1 41.1 .., f W O O : N O O O '�• O `: O O k nl O µ „M ( p O sR dry O O ~. O O O N m Ir co LU � Y ti+JM Rt i y N 6 tl a y ^ ^ C4 ^ ~ y tgS � N V ^ I y N � �s TTOO•5� 46 x N _ $ N M F r 40 w � d HM !w � LL D. JV sTCjxj 2 y m U � Ea g `y�y�' F a� N !— w rIN c r UNIFORM GRANT APPLICATION TOTAL AGENCY BUDGET AGENCYIPROGRAM NAME:Center for Emotional & Behaviorial Health/ Parenting Class FY 0W/04 FY 0"S FY 05106 % INCREASE FYE_Nf30l2004 FYE_9W/M5 FYE_9/30!2006 CURRENTVS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (coL C-col. BycoL e REVENUES BUDGETED BUDGETED 1 Children's Services CouncilSt. Lucie 0.00 #DIV/O! 2 Children's Services Council-Martin 0.00 #DIV/OI 3 Advisory Committee-lndian River 20 000.00 24 445.00 167 818.13 586.51 % 4 United Way-St Lucie County0.00 #DIV/O! United Way-Martin County0100 #DIV/p! s United Way-Indian River Count0.00 #DIV/01 7 Department of Children & Families 0.00 #DIV/0! s CountyFunds 0.00 #DIV/O! 9 Contributions-Cash 0.00 #DIV/O! to Program Fees792249445.00 7 348 000. 7j3OOjOOO,OO 0,65% ii Fund Raising Events4*1: 0.00 #DIV/01 12 Sales to Public-Net 0.00 #DIV/0! 73 Membershi Dues 0.00 #DIV/01 14 Investment Income 0.00 #DIV/01 is Miscellaneous : 0.00 ODIV/0! 16 Legacies 8 Bequests 2 000.00 #DIV)01 17 Funds from Other Sources 0100 #DIV/01 16 Reserve Funds Used for Operating0.00 #DIV/O! 19 In-IQndDonations pmkwkwedin q 0.00 #Di1//01 TOTAL 79244s"5,00 7 37 445.001 746981813 1 .32% EXPENDITURES 21 Salaries 3,67do766,001 4 O80 009. 420 409.27 3.00% 22 FICA 259t962,001 293975&001 321484.31 9.44% 23 Retirement �1"J29,231 1592936,3M 164 734. 3,00% 24 LifeMealth 487 906. 54im417,191 557s659.71 3.00% 2s Workers Compensation 61034. 67 728.15 69j759.W 3.00% 26 Florida UnemploymentM 6 250. 6P936.02 7144.10 3.00% l-0a 27 Travel2g71OOOj 3 080.00 3172.40 3.00% 28 Travel/Conferences/Training 43r995,OOI 43,995 45,140,40 2.60% 29 Office Supplies. 50,219,001 44 529.0.0 529. . 6.00% Telephone 589.25 29 473.45 30 385.00 3.09% 37 Postage/Shipping4s499,0,0 Z922.00 69060,00 107.39% 32 Utilities 612.00 650000.00 70 200.00 8.00% 33 Occupancy (Building & Grounds 87 405. 8882981 891 320.81 0.26% m Printin & Publications 857.00 3,000.00 3120.00 4.00% 3s Subsarl bersh 317.00 5556.00 5556.00 . 0.00% 36 Insurance I �40%660,00 3759675,00 375 000. 00015% V EquipmentRental S Maintenance 14 029.00 172568, 17v5OO,OOj 0,39% Advertisin 50000,00 51000100 5000.00 0.00% 39 Equitunent Purchases:CapW Expense 11274.00 89647,00 9000.00 4.08% 40 Professional Fees CLegak Consulting) 287, 2289612,00 2289612.00 0.00% 41 BookslEducationai Materials 20 606.00 29 080.00 29 080.00 0.00% 42 Food & Nutrition 137 328.00 141 600. 118 038. -16.64% 43 Administrative Costs 424 365. 430 730.48 47Z795,75 9.77% Audit Fit 0.00 0.00 0.00 7fD11//O! 4s Specific Assistance to individuals 0.00 0.00 0.00 #1X1//0! 46 Other/Miseellaneous 800.00 800.00 1575.00 96.88% 47 OthedContract 871o908,00 87 000.00 87Z000,00 0.00% 4s TOTAL T 911509.1 89345928*64 8551276.18 2.46% ,�,� -_�. . � 49 REVENUES OVER/ UNDER EXPENDITURES -67 064.1 -973j483,64 -1 081 .458.05 11 .09% sn7rM • a. A1. GCJtJJ J. .� • •f�{ ('ll J fC + J. f r NU 1 354 Ru ACMD. CERTIFICATE OF LIABILITY INSURANCE =>�I,�px �iiMW a a PRDIotILfR I THIS CERTIFICATC IS ISSUED AS A MATTER OF Ot1FORMATIon ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE DO NOT UV T MOLDER, THIS CERTIFICATE DOES WTAMEno, EXTEND OR 6529 Morrison Blvd „ suite 200 ALTERNFCOVERAGE AFFORDED aYTHE P�OLIOICSBELOW. Charlotte MC 2 $ 211 thonea100 - 729 - 4F14 ) fMv704 - 365 - 7114 INSURERBAFFORDINGCOVERAGE IIIAIC4Y INSUMPIEUWRA: Admiral Znvurance Co . pR— . ..�.r.—�w.... .....-. .. r .n. ... ..... . � . . - .�.. r .o. nf. *. �.�........ INSURER e: AwArteAe Autw► a ,v No. ca . i,ndgiA'a River M=arial Rospital 1000 Mo36CTi Street IINSVRERC - ere Soach PL 32960 INSURNN I! : COVERAGES THE rotcKs or INSWUNCP Lima 014OW NAV_ BEEN 16SUFO TO THE I19SUR615NAMCD ABOVE FOR 74 006iCy OpIoD IhOIOATEO. wOTWft1?ANOrNG ANY REOUIREMMCNY, TERM OR worrioN OT ANY CONTRACT OR OTMER OD06W ENT AfITM RCOPCOT TO WMICM 71441 CFATIFIGATS MAY M ISMO ON MAY PMAMI, THE INSVWCi AATOROEO VY THE POUCISS OESCROE0 HEREIN 4 W14ECT TO ALL TME TIERMS. EXCLUSIONS ANO CONOMONS OF SUCH POLICAMs A54ftCATE UMTS SMtOWW f4AY MA BEEN REOUCEO OY PAID CLAINS, UAANC 006ICY NUlIsfIII ROA91MW A ■ UM IS MMALLIAP"ry j EACNOCCLIRitjNCE 1115000OV000 X 19 COMWJ%M OENERAI LIAMLM' CAPTIVN SZR 11 / 01 / 05 11/01/ 06 ��ttEWIeRP � e f X CLAPw1S WNoti O^.wR �MEO IM MAY mepww) 1 j N9POON&A & APV NAM 1 ! 5 . 000 . 400 G1MMLA(IMOAM a $ 15 , 000 , 000 ML AOGACCIATE UM Y APPLIES PER: _ I'M , PtvoaucTl • coMProPAG>; 3 $ 540000000 pmL � . . . Lac - - - -- ALITOWII&C LMMUM I r GgNRIryCp tIpOLE LIMB ! �t � � g Q 0 r 0 0 0 ANY AUTO j (Ee reehrRl ALL OWNED ALROS IJ �plty IµJURv C B X SCnEOIAEOAMS IMZA90833367 11 / 01 / 05 I1/ 01 / 06 IPa, pen°nl >D x MPWMAUTOa I Mx.A60633367 11 / 01 / 05 10, / 01 / 06 IODILYMLURY ! $ 8 MON YMMAUTrs I KZABO033367 Li/ OLj65 11 / 01 /06 �e "xf0en1� . j PROPERTY DAMAGE 1 . .._. . . ,_ . . , I F+r &*dw) CARAGELVBtllry AUYOONLY - FAACCIOENT Is ANY AUTO MER THAN CA AOC 1 ALITOONLr' ,G, i UCECt MIWLLA LMtLrry CACNOCC{Aif6NCE i $Z0 , 000 , 000 A CZCUA x CLAUS IVAOt CRL - M - 1003. 3 - 1002 - 04 11 / 01 / 05 i 11 / 01 / 06 Acaps 71 sfROr000 , 000 ' Idcrese _ s DEOLICTIBIE Above SIR 1 RETENTION 1 Rl" 1;16/ $ ism ! woaeeRecolepawaTrOMANo I ; roeTVLwrts ' ER EMPLOYERT U UTY ry ARTNERJCX6CVTIVE E.l. EACN A0CCIDENT PROPRIETOWPi FIe6ft44ev R tCxCLwEb* I i I t:.L. DdS' W • EA MftOYF t _ Wdagoom antler M PROVISIONS bares t .L. OMEASE - POLICY LW 15 oT„ay�e DESCRIPTION OI. O►EIIATIONC I LOCATIONS I VEHICLES l 15KCLUSIONSOZOED By MNOOMSEMENT I SPECIAL PRDVMO%$ Certificate Holder in added as Additional Xneurea with reopect to their interest in contract with the samd Iusured . OMTIFICATE HOLDER CANCELLATION LliDIriaTC SHOULD ANY OP TMs AVOW MCRIM POL(Oft K CANORL 4110 NDIFURC TKR' t9FMATM 6ATtt TMEAMOr', T/rE 11*UIMO INSURED tVll.l ENOrwvDA SCI pyyw 0 PAY$ "RIYTBN NOTIOC YO TK{ CARTIAICATT NDLDBR NAPAS9 TO IME, AOFTI BVT FAA.YRO TO 00 SO &KA" Iridian River County IMPOSE NO OBLIGATION OR UAZIL TY OF ANY MIND UPON TIM IMUROM, ITR AGENTS OR 1640 26th Street REPRE TATM Vero BArAch HL 32960 AUT R&WV1TA4fVM I ACCRO Z5 (Z M106) 9 ACORD CORPORATION i9se NU . 5UQ 003 AACaV� CERTIFICATE OF LIABILITY INSURANCE �AT� IMM�OYwY1 o� _ z Si 05 PRoovC �l TM8 CERTIFICATE 14 ISSUED AS A MATTER CCONLYNDF MfFORMATIOM Ploti�s 8oapital TE Assoc xnim Svc HOLDIFL THISe T IS CIFICATE DOES NOTAMENDDO EXTRIGHTS UPON THE #NDOR 1675 Terrell Kill Rd * , ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, X4rictrtn GA 70067 Fhoae : 800 - 476 - 7001 Pax : 770 , 8SCw0gq # INSURERS AFFORDING COWRAGE rye * INWRER A: fia�c�l c�.wer "'*for Zndf,iatla River xamorial U08pital INSURERR Gre MO aRa INSURER C: 31009 36th srraej98 0 Vero 11000 YL, 3 a I I"su"e" tN�URf R E; C WKIAGES TME POLICIES OF MVRANCE LISTED MOW MAVE BEEN ISSVED TC T111 IN5LqEONA7m@0 ABOVE FOR THE FOUCY PERIOP INDICATC, ROTA MSTANOINC ANY R VMfMFMT, TERN OR CONORION OF ANY CONTkAC? CR OTHF,R DOCUNf.Pe K/ITM RE$PGCTTO wMICM TMI3 QERTICICATE MAYBE t9ilto oR MAY 'pCFITAIN, TMG NCUMNCC AFFOROLO lv TME t'CL C ICS OCSCR!BEO M1:RCtN IS SUBJECT 7C A'�L TI- E 7QR►,19, WCCLVS10N8 ANDCONOITloM Or "14 MLCIEi . A60ACCA% LIM" 6t OWN 94AY NAVE I615N RBDVM BY PATO CLAiWgm lMtAIuCB POLICY NUMSIRRATION OSNApAL LIAAI< RY ; tG6" OCCURRENCE f i COtVNNERCULL OGMCML LIABR,17Y I I;PIN��oCunRetrt f _ —•.•_ •. CLAOM WE OCCUR MED FA SMY0% Pmonl f 'ER90NALbAOVIWAY S �OLNIPALAGOREGArf S LffN'I�AQLIRR_Oh71'E�U a MPLIES FCR i PRti�i - COAIFft1P aGG I f r AUTOROVU IWILRY I W "COMBINED &VOU LIMIT AWYAVfO 1 ALL QAINfiO ALrtOB --^---- - BODILY 1KJLWV f SCMEOVLEO AUTOS (Poe Pwmni Mow* AWY03 900I6Y INAW NONiWNgED AVMS I p+r Kda"t) : --� —� - - I PROPERTY OM*GE f (Pr wdaanq WRACEL11")LI►V 4VTOONLY - EAACCIOw i ti AUTO ^ AWAUTO OTHERTMAK EA ACC f /µ17p ONLY: A00 f !%GEJ!lRINNRlLLALU1iTtIT1 I CACMOCCUWt@10E is OCCVR Q CLtIMSMAUC A(1t3REGATE -r�.....�� f f DEDUCTIBLI ' f j� RfTEN710F1 f � f - wOgKEltf COMPIENSAMN AND BNPIOVERO' LIABILTI X - MITE ER A w - ] zd5884367e 01 / 01 / 05 i 01 ! 01/ 06 CL, EACHA1;peXNT s ¢i , 000jr ANY PROPRIE'lURAWt CtJT1VC _ oaPlcavME►eeER Ex uoEo1 I E L. olefAliE iA+PLors ; i . 0 0 0 a 0 Q V .. AL PROlba VAJO ( E.L. OIAEAsE - nOLOYLMIr f l 000 . 000 s�EaAL PROv;SaNE wrr OTKER i M I;RIPYION VF OPBRAYIORS I LOCATIONS i VERMOM ' VXCLUSWM ADUK0 ■v Cry SMENI t CPECIAL F'1WVIS10N7 ArooS of rovera>�+ has Indian Raver D[ec:oriex 1Rospital . CiRTIFICATE HOWNR CANCELLATION DMIAN r SNOXILO ANY OF ONE Ap0VE DU0ptAerp nWCIES 0E CANOILLBp aIBFORE TMC ENPYIA DATE 714ERECF,.ThE ISSU" INPVRCR W 4l 140!4#40" TO WWI, 30 PAYI YAtlrTCN NOTICE YO YHE CC'RYTFIOATE MOLDER NAMED TO "V- LEFT, W FAIWRR TO 2050 SNAL: xrLdi aA ii1'Io r CouriCp IMPOSE NO ORUCAMON OR LIANOTYOP ANY RIND UPON TME N$URERt rra AQ&"m ON 1060 49th Street RP5 ATN6S, Vero Bunch PI, 32960 Aur ioREPW ITA Y6 ACORp Zs t200�roa► 0 ACORO CORPORATION 1988 CMw N Ewwtb YfD hs%4wWH WJ Pww" CWs UNIFORM GRANT APPLICATION TOTAL PROGRAM BUDGET AGENCY/PROGRAM NAME:Center for Emotional & Behaviorial Health/ Parenting Class 03104 FY 04105 FY OSM % INCREASE FYE_913W2W4 FYE_9/301 M FYE CURRENT VS. NEXT FY BUDGET A B C D ACTUAL TOTAL PROPOSED (Col. CtoL BpooL B REVENUES BUDGETED BUDGETED 1 Children's Services Council-St Lucie 0.00 #DIV/0! 2 Children's Services Council-Martin 0.00 #DNPoI 3 Advisory Committee-Indian River 965742 #DIVPo! United Way-St. Lucie County0.00 #DIVAH s United Way-Martin County 0.00 #DIVPo! I; United Way-Indian River County0.00 #DNPo! 7 Department of Children S Families 0.00 #DIVPo! a CountyFunds 0.00 #DIV/Ot 9 Contributions-Cash 0.00 #DN/O! 10 Program Fees . 0.00 . #DIV/O! 11 Fund Raising Events-Net 0.00 #DNPo! 12 Sales tO Public-Net 0.00 #DIVAH 13 Membership Dues 0.00 tIDNPo! 14 Investment Income 0.00 #DIVPoI 1s Miscellaneous 0.00 ilpNPot is Legacies & Bequests 0.00 #DNPoI v Funds from Other Sources 0,00 #DNPo! 1B Reserve Funds Used for Operating 0.00 #DIVPoI i9 in4Qnd Donations (Na lnelj4.d In long 1837.50 . #DIVAN 20 TOTAL 0.00 . 0.00 99657,42 #DIVPo! EXPENDITURES 21 Salaries 6j921 ,60 #DIVPoI zx FICA 529.50 #DIVPo! 23 Retirement 174.42 #DIVPoI 24 LlfeAiealtir 590.46 #DIVAH 25 orkers CoMpgnsation 73.86 #DIVAH 26 Florida Unem ment . 7w56 mm, 27 Travel-Dai 0.00 #DIVPoI 2a TravoYConferences/Traini 0:00 #DIV/O! 2.9 Offic4supplies 210.00 #DIVPoI 3o T hone 100.00 #DIVAH31 P hi in 100.00 #DIVJOI 32 Utilities 300.00 #DNPoI 33. Occupancy (Building B Grounds 575.00 #DIVAH 34 Pri S Publications 50.00 #=/01 36 SubscripbontpuesnAemberships100.00 #WVPoI 36 Insurance 787.50 #DIVAH 37 E ui ent:Rentai 8-Maintenance 0.00 #DIVPoI. 38 Advertising0.00 #DIV/01 39 E4ulpment Purchase*:Capitid Expensem 0,00 #DNPo! 40 Professional Fees L 1 Consulting) 0.00 #DNPot 41 BOOkS/EduCational Materials 800.00 #DIV/0t 42 Food S Nutrition 0.00 #DIVAH 43 Administrative Costs 1050.00 #DNPoI 44 Audit Expense 0.00 #DIVAH 45 Specific Assistance to individuals0.00 #DIVPo! 46 Other/Miscellaneous 0.00 #DN/OI 47 OtheNContract 0.00 #DNroI 48 TOTAL 0.00 0.00 142369,92 #DIVAH 49 REVENUES OVER/ UNDER EXPENDITURES 0.00 0.001 .4 2712.50 #DNPoi. . �� ea I 1 Center for Emotional & Behavioral HealW Parenting Class UNIFORM GRANT APPLICATION FUNDER SPECIFIC BUDGET PROGRAM EXPENSES AGENCY/PROGRAM NAME : Center for Emotional & Behaviorial Health/Parenting Class FUNDER : IRC - CSAC A B C FY 05/06 FY 05/06 % OF TOTAL FUNDER TOTAL VS. PROGRAM SPECIFIC FUNDER REQUEST BUDGET BUDGET col. B/col. A) EXPENDITURES 21 Salaries 6,921 .60 6,921 .60 100.00% 22 FICA 529.50 529.50 100.00% 23 Retirement 174.42 174.42 100.000% 24 Life/Health 590.46 590.46 100.00% 25 Workers Compensation 73.86 73.86 100.00% 26 Florida Unemployment 7.56 7.56 100.00% 27 Travel-Dai 0.00 . 0.00 0DN/01 28 Travel/Conferences/Training 0.00 0.00 #DN/01 29 Office Su lies 210.00 210.00 100.00% 30 Telephone 100.00 100.00 100.00% 31 Postage/Shipping 100.00 100.00 100.00% 32 Utilities 300.00 0.00 0.00% 33 Occupancy` (Building & Grounds 2,575.00 0.00 0.00% 34 Printing & Publications 50.00 50.00 100.00% 35 Subscri tion/Dues/Membershi s 100.00 100.00 100.00% 36 Insurance. 787.50 0.00 0.00% 37 Eoui rnent: Rental & Maintenance 0.00 0.00 4DIV/01 38 Advertlsin 0.00 0.00 #DN/01 39 Equipment Purchases: Ca ital Expense 0.00 0.00 #DN/01 40 Professional Fees (Legal, Consulting) 0.00 0.00 #DN/0 ! 41 BookslEducatlonal Materials 800.00 800.00 100.00% 42 Food & Nutrition 0.00 0.00 9DN/01 43 Administrative Costs 11050.00 0.00 0.000/0 44 Audit Expense 0.00 0.00 #DN/0 ! 45 Specific Assistance to Individuals 0.00 0.00 #DN/01 46 Other/Miscellaneous 0.00 0.00 #DN/01 47 Other/Contract 0.00 0.00 #DN/0 ! 48 TOTAL $14,369.92 $9,657.42 67.21 % SPIMM E" EXHIBIT B ( From policy adopted by Indian River County Board of county Commissioners on February 19 , 2002 ) " D . Nonprofit Agency Responsibilities After Award Funding Indian River County provides funding to all nonprofit agencies on a reimbursement basis only. All reimbursable expenses must be documented by an invoice and/or a copy of the canceled check . Any expense not documented properly to the satisfaction of the Office of Management & Budget and/or the County Administrator may not be reimbursed . If an agency repeatedly fails to provide adequate documentation , this may be reported to the Board of Commissioners . In the event an agency provides inadequate documentation on a consistent basis , funding may be discontinued immediately. Additionally, this may adversely affect future funding requests . Expenditures may only be reimbursed from the fiscal year for which funding was awarded . For example , no expenditures prior to October 1St may be reimbursed with funds from the following year. Additionally, if any funds are unexpended at the end of a fiscal year, these funds are not carried over to the next year unless expressly authorized by the Board of Commissioners . All requests for reimbursement at fiscal year and (September 30th) must be submitted on a timely basis . Each year, the Office of Management and Budget will send a letter to all nonprofit agencies advising of the deadline for reimbursement requests for the fiscal year. This deadline is typically early to mid October, since the Finance Department does not process checks for the prior fiscal year beyond that point. Each reimbursement request must include a summary of expense by type . These summaries should be broken down into salaries , benefit , supplies , contractual services , etc . If Indian River County is reimbursing an agency for only a portion of an expense (e . g . salary of an employee ), then the method for this portion should be disclosed on the summary. The Office of Management & Budget has summary forms available . Indian River County will not reimburse certain types of expenditures . These expenditure types are listed below. a ) Travel expenses for travel outside the County including but not limited to : mileage reimbursement, hotel rooms , meals , meal allowances , per diem , and tolls . Mileage reimbursement for local travel (within Indian River County) is allowable . b ) Sick or Vacation payments for employees . Since agencies may have various sick and vacation pay policies , these must be provided from other sources . c) Any expenses not associated with the provision of the program for which the County has awarded funding . d ) Any expense not outlined in the agency's funding application . The County reserves the right to decline reimbursement for any expense as deemed necessary. " EXHIBIT - B - EXHIBIT C STANDARD TERMS FOR GRANT CONTRACT 1 . Notices . Any notice , request, demand , consent, approval , or other communication required or permitted by this Contract shall be given , or made in writing , by any of the following methods : facsimile transmission ; hand delivery to the other party; delivery by commercial overnight courier service ; or mailed by registered or certified mail (postage prepaid ) , return receipt requested at the addresses of the parties shown below : County: Joyce Johnston-Carlson , Director Indian River County Human Services 184025 th Street Vero Beach , Florida 32960-3365 Recipient : CEBH - Center for Emotional & Behavioral Health 119037 th Street Vero Beach , Florida 32960 Attention : Mariamma Pyngolil , RN , Program Director 2 . Venue ; Choice of Law. The validity, interpretation , construction , and effect of this Contract shall be in accordance with and governed by the laws of the State of Florida only. The location for settlement of any and all claims , controversies , or disputes , arising out of or relating to any part of this Contract, or any breach hereof, as well as any litigation between the parties , shall be Indian River county, Florida for claims brought in state court, and the Southern District of Florida for those claims justifiable in federal court. 3 . Entirety of Agreement. This Contract incorporates and includes all prior and contemporaneous negotiations , correspondence , conversations , agreements , and understandings applicable to the matters contained herein and the parties agree that there are no commitments , agreements , or understandings concerning the subject matter of this Contract that are not contained herein . Accordingly, it is agreed that no deviation from the terms hereof shall be predicated upon any prior representations or agreements , whether oral or written . It is further agreed that no modification , amendment or alteration in the terms and conditions contained herein shall be effective unless contained in a written document signed by both parties . 4 . Severability. In the event any provision of this Contract is determined to be unenforceable or invalid , such unenforceability or invalidity shall not affect the remaining provisions of this Contract, and every other provision and term of this Contract shall be deemed valid and enforceable to the extent permitted by law. To that extent, this Contract is deemed severable . 5 . Captions and Interpretations . Captions in this Contract are included for convenience only and are not to be considered in any construction or interpretation of this Contract or any of its provisions . Unless context indicates otherwise , words importing the singular number include the plural number, and vise versa . Words of any gender include the correlative words of the other genders , unless the sense indicates otherwise . 6 . Independent Contractor. The Recipient is and shall be an independent contractor for all purposes under this Contract . The Recipient is not an agent or employee of the County, and any and all persons engaged in any of the services or activities funded in whole or in part performed pursuant to this Contract shall at all times and in all places be subject to the Recipient's sole direction , supervision and control . 7 . Assignment . This Contract may not be assigned by the Recipient without the prior written consent of the County. EXHIBIT - C - • a. A1. GCJtJJ J. .� • •f�{ ('ll J fC + J. f r NU 1 354 Ru ACMD. CERTIFICATE OF LIABILITY INSURANCE =>�I,�px �iiMW a a PRDIotILfR I THIS CERTIFICATC IS ISSUED AS A MATTER OF Ot1FORMATIon ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE DO NOT UV T MOLDER, THIS CERTIFICATE DOES WTAMEno, EXTEND OR 6529 Morrison Blvd „ suite 200 ALTERNFCOVERAGE AFFORDED aYTHE P�OLIOICSBELOW. Charlotte MC 2 $ 211 thonea100 - 729 - 4F14 ) fMv704 - 365 - 7114 INSURERBAFFORDINGCOVERAGE IIIAIC4Y INSUMPIEUWRA: Admiral Znvurance Co . pR— . ..�.r.—�w.... .....-. .. r .n. ... ..... . � . . - .�.. r .o. nf. *. �.�........ INSURER e: AwArteAe Autw► a ,v No. ca . i,ndgiA'a River M=arial Rospital 1000 Mo36CTi Street IINSVRERC - ere Soach PL 32960 INSURNN I! : COVERAGES THE rotcKs or INSWUNCP Lima 014OW NAV_ BEEN 16SUFO TO THE I19SUR615NAMCD ABOVE FOR 74 006iCy OpIoD IhOIOATEO. wOTWft1?ANOrNG ANY REOUIREMMCNY, TERM OR worrioN OT ANY CONTRACT OR OTMER OD06W ENT AfITM RCOPCOT TO WMICM 71441 CFATIFIGATS MAY M ISMO ON MAY PMAMI, THE INSVWCi AATOROEO VY THE POUCISS OESCROE0 HEREIN 4 W14ECT TO ALL TME TIERMS. EXCLUSIONS ANO CONOMONS OF SUCH POLICAMs A54ftCATE UMTS SMtOWW f4AY MA BEEN REOUCEO OY PAID CLAINS, UAANC 006ICY NUlIsfIII ROA91MW A ■ UM IS MMALLIAP"ry j EACNOCCLIRitjNCE 1115000OV000 X 19 COMWJ%M OENERAI LIAMLM' CAPTIVN SZR 11 / 01 / 05 11/01/ 06 ��ttEWIeRP � e f X CLAPw1S WNoti O^.wR �MEO IM MAY mepww) 1 j N9POON&A & APV NAM 1 ! 5 . 000 . 400 G1MMLA(IMOAM a $ 15 , 000 , 000 ML AOGACCIATE UM Y APPLIES PER: _ I'M , PtvoaucTl • coMProPAG>; 3 $ 540000000 pmL � . . . Lac - - - -- ALITOWII&C LMMUM I r GgNRIryCp tIpOLE LIMB ! �t � � g Q 0 r 0 0 0 ANY AUTO j (Ee reehrRl ALL OWNED ALROS IJ �plty IµJURv C B X SCnEOIAEOAMS IMZA90833367 11 / 01 / 05 I1/ 01 / 06 IPa, pen°nl >D x MPWMAUTOa I Mx.A60633367 11 / 01 / 05 10, / 01 / 06 IODILYMLURY ! $ 8 MON YMMAUTrs I KZABO033367 Li/ OLj65 11 / 01 /06 �e "xf0en1� . j PROPERTY DAMAGE 1 . .._. . . ,_ . . , I F+r &*dw) CARAGELVBtllry AUYOONLY - FAACCIOENT Is ANY AUTO MER THAN CA AOC 1 ALITOONLr' ,G, i UCECt MIWLLA LMtLrry CACNOCC{Aif6NCE i $Z0 , 000 , 000 A CZCUA x CLAUS IVAOt CRL - M - 1003. 3 - 1002 - 04 11 / 01 / 05 i 11 / 01 / 06 Acaps 71 sfROr000 , 000 ' Idcrese _ s DEOLICTIBIE Above SIR 1 RETENTION 1 Rl" 1;16/ $ ism ! woaeeRecolepawaTrOMANo I ; roeTVLwrts ' ER EMPLOYERT U UTY ry ARTNERJCX6CVTIVE E.l. EACN A0CCIDENT PROPRIETOWPi FIe6ft44ev R tCxCLwEb* I i I t:.L. DdS' W • EA MftOYF t _ Wdagoom antler M PROVISIONS bares t .L. OMEASE - POLICY LW 15 oT„ay�e DESCRIPTION OI. O►EIIATIONC I LOCATIONS I VEHICLES l 15KCLUSIONSOZOED By MNOOMSEMENT I SPECIAL PRDVMO%$ Certificate Holder in added as Additional Xneurea with reopect to their interest in contract with the samd Iusured . OMTIFICATE HOLDER CANCELLATION LliDIriaTC SHOULD ANY OP TMs AVOW MCRIM POL(Oft K CANORL 4110 NDIFURC TKR' t9FMATM 6ATtt TMEAMOr', T/rE 11*UIMO INSURED tVll.l ENOrwvDA SCI pyyw 0 PAY$ "RIYTBN NOTIOC YO TK{ CARTIAICATT NDLDBR NAPAS9 TO IME, AOFTI BVT FAA.YRO TO 00 SO &KA" Iridian River County IMPOSE NO OBLIGATION OR UAZIL TY OF ANY MIND UPON TIM IMUROM, ITR AGENTS OR 1640 26th Street REPRE TATM Vero BArAch HL 32960 AUT R&WV1TA4fVM I ACCRO Z5 (Z M106) 9 ACORD CORPORATION i9se NU . 5UQ 003 AACaV� CERTIFICATE OF LIABILITY INSURANCE �AT� IMM�OYwY1 o� _ z Si 05 PRoovC �l TM8 CERTIFICATE 14 ISSUED AS A MATTER CCONLYNDF MfFORMATIOM Ploti�s 8oapital TE Assoc xnim Svc HOLDIFL THISe T IS CIFICATE DOES NOTAMENDDO EXTRIGHTS UPON THE #NDOR 1675 Terrell Kill Rd * , ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, X4rictrtn GA 70067 Fhoae : 800 - 476 - 7001 Pax : 770 , 8SCw0gq # INSURERS AFFORDING COWRAGE rye * INWRER A: fia�c�l c�.wer "'*for Zndf,iatla River xamorial U08pital INSURERR Gre MO aRa INSURER C: 31009 36th srraej98 0 Vero 11000 YL, 3 a I I"su"e" tN�URf R E; C WKIAGES TME POLICIES OF MVRANCE LISTED MOW MAVE BEEN ISSVED TC T111 IN5LqEONA7m@0 ABOVE FOR THE FOUCY PERIOP INDICATC, ROTA MSTANOINC ANY R VMfMFMT, TERN OR CONORION OF ANY CONTkAC? CR OTHF,R DOCUNf.Pe K/ITM RE$PGCTTO wMICM TMI3 QERTICICATE MAYBE t9ilto oR MAY 'pCFITAIN, TMG NCUMNCC AFFOROLO lv TME t'CL C ICS OCSCR!BEO M1:RCtN IS SUBJECT 7C A'�L TI- E 7QR►,19, WCCLVS10N8 ANDCONOITloM Or "14 MLCIEi . A60ACCA% LIM" 6t OWN 94AY NAVE I615N RBDVM BY PATO CLAiWgm lMtAIuCB POLICY NUMSIRRATION OSNApAL LIAAI< RY ; tG6" OCCURRENCE f i COtVNNERCULL OGMCML LIABR,17Y I I;PIN��oCunRetrt f _ —•.•_ •. CLAOM WE OCCUR MED FA SMY0% Pmonl f 'ER90NALbAOVIWAY S �OLNIPALAGOREGArf S LffN'I�AQLIRR_Oh71'E�U a MPLIES FCR i PRti�i - COAIFft1P aGG I f r AUTOROVU IWILRY I W "COMBINED &VOU LIMIT AWYAVfO 1 ALL QAINfiO ALrtOB --^---- - BODILY 1KJLWV f SCMEOVLEO AUTOS (Poe Pwmni Mow* AWY03 900I6Y INAW NONiWNgED AVMS I p+r Kda"t) : --� —� - - I PROPERTY OM*GE f (Pr wdaanq WRACEL11")LI►V 4VTOONLY - EAACCIOw i ti AUTO ^ AWAUTO OTHERTMAK EA ACC f /µ17p ONLY: A00 f !%GEJ!lRINNRlLLALU1iTtIT1 I CACMOCCUWt@10E is OCCVR Q CLtIMSMAUC A(1t3REGATE -r�.....�� f f DEDUCTIBLI ' f j� RfTEN710F1 f � f - wOgKEltf COMPIENSAMN AND BNPIOVERO' LIABILTI X - MITE ER A w - ] zd5884367e 01 / 01 / 05 i 01 ! 01/ 06 CL, EACHA1;peXNT s ¢i , 000jr ANY PROPRIE'lURAWt CtJT1VC _ oaPlcavME►eeER Ex uoEo1 I E L. olefAliE iA+PLors ; i . 0 0 0 a 0 Q V .. AL PROlba VAJO ( E.L. OIAEAsE - nOLOYLMIr f l 000 . 000 s�EaAL PROv;SaNE wrr OTKER i M I;RIPYION VF OPBRAYIORS I LOCATIONS i VERMOM ' VXCLUSWM ADUK0 ■v Cry SMENI t CPECIAL F'1WVIS10N7 ArooS of rovera>�+ has Indian Raver D[ec:oriex 1Rospital . CiRTIFICATE HOWNR CANCELLATION DMIAN r SNOXILO ANY OF ONE Ap0VE DU0ptAerp nWCIES 0E CANOILLBp aIBFORE TMC ENPYIA DATE 714ERECF,.ThE ISSU" INPVRCR W 4l 140!4#40" TO WWI, 30 PAYI YAtlrTCN NOTICE YO YHE CC'RYTFIOATE MOLDER NAMED TO "V- LEFT, W FAIWRR TO 2050 SNAL: xrLdi aA ii1'Io r CouriCp IMPOSE NO ORUCAMON OR LIANOTYOP ANY RIND UPON TME N$URERt rra AQ&"m ON 1060 49th Street RP5 ATN6S, Vero Bunch PI, 32960 Aur ioREPW ITA Y6 ACORp Zs t200�roa► 0 ACORO CORPORATION 1988